MEDICARE: DENNIS QUINTON LCSW, LCDC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	13275	TX
2	1041C0700X	Clinical Social Worker	64905	TX

General Provider Information

NPI Number	:	1164882312
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DENNIS QUINTON LCSW, LCDC

Provider Business Mailing Address
First Line	:	5200 HARRY HINES BLVD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75235-7709
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4606 CEDAR SPRINGS RD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75219-1299
Country	:	US
Telephone Number	:	469-590-8000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/01/2016
Last Update Date	:	01/21/2025

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