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General NPI Number Information
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NPI Number | 1154489789
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Entity Type | Individual
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Provider Name | JOSEPHINE CASSIDY-QUINN LICSW, LADC
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Gender | Female
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Dates
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Enumeration Date | 12/05/2006
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Last Update Date | 01/27/2016
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Provider Practice Location Address
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Address Line | 2112 RIVERDALE ST
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City | WEST SPRINGFIELD
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State | MA
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Zip | 01089-1024
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Country | US
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Telephone | 413-827-4269
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Fax | 413-827-4204
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Provider Business Mailing Address
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Address Line | 1233 MAIN ST
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City | HOLYOKE
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State | MA
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Zip | 01040-5381
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Country | US
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Telephone | 413-493-2075
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Fax | 413-539-2436
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 113845
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License Number State | MA
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