Healthcare Provider Details

I. General information

NPI: 1457159691
Provider Name (Legal Business Name): QUIN MARILYN RICH MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/04/2025
Last Update Date: 08/13/2025
Certification Date: 08/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

118 MAPLE ST UNIT 1
EASTHAMPTON MA
01027-1716
US

IV. Provider business mailing address

3420 HALLIDAY AVE
SAINT LOUIS MO
63118-1102
US

V. Phone/Fax

Practice location:
  • Phone: 314-303-2528
  • Fax:
Mailing address:
  • Phone: 314-303-2528
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW025927
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLICSW1140622
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2025005431
License Number StateMO

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: