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General NPI Number Information
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NPI Number | 1467973644
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Entity Type | Individual
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Provider Name | ALEXANDRA MANGO QUINN LMHC
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Gender | Female
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Dates
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Enumeration Date | 06/28/2017
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Last Update Date | 04/01/2025
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Provider Practice Location Address
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Address Line | 1385 LAKEVIEW AVE
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City | DRACUT
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State | MA
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Zip | 01826-3414
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Country | US
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Telephone | 978-256-4363
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Fax |
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Provider Business Mailing Address
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Address Line | 17 INNERBELT RD
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City | SOMERVILLE
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State | MA
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Zip | 02143-4418
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Country | US
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Telephone |
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Fax |
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LMHC5000952
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License Number State | MA
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