Healthcare Provider Details

I. General information

NPI: 1164655650
Provider Name (Legal Business Name): STEPHEN QUINN PSY.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2009
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1499 CHAIN BRIDGE RD STE 202
MC LEAN VA
22101-5704
US

IV. Provider business mailing address

1499 CHAIN BRIDGE RD STE 202
MC LEAN VA
22101-5704
US

V. Phone/Fax

Practice location:
  • Phone: 703-819-8816
  • Fax:
Mailing address:
  • Phone: 703-819-8816
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number0810004037
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: