Healthcare Provider Details

I. General information

NPI: 1780142711
Provider Name (Legal Business Name): QUINN K SMELSER NCC, LPC, RPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/08/2019
Last Update Date: 04/09/2021
Certification Date: 03/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 HIGH PARK LN APT 135
SILVER SPRING MD
20910-3192
US

IV. Provider business mailing address

180 HIGH PARK LN APT 135
SILVER SPRING MD
20910-3192
US

V. Phone/Fax

Practice location:
  • Phone: 512-739-9426
  • Fax:
Mailing address:
  • Phone: 512-739-9426
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0701007878
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLC11053
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: