MEDICARE: CATHERINE QUINN KERINS PHD LLC

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	261QM0850X	Adult Mental Health Clinic/Center
2	103T00000X	Psychologist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1881751485	OTHER	PA	AETNA, INDEPENDENCE BC/BS, KEYSTONE, PERSONAL CHOICE, HIGHMARK, UBH, BEACON

General Provider Information

NPI Number	:	1225694755
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CATHERINE QUINN KERINS PHD LLC

Provider Business Mailing Address
First Line	:	2960 W GERMANTOWN PIKE STE A
Second Line	:
City	:	NORRISTOWN
State	:	PA
Zip	:	19403-1060
Country	:	US
Telephone Number	:	610-631-9298
Fax Number	:	610-630-2200

Provider Business Practice Location Address
First Line	:	2960 W GERMANTOWN PIKE
Second Line	:
City	:	NORRISTOWN
State	:	PA
Zip	:	19403-1060
Country	:	US
Telephone Number	:	610-631-9298
Fax Number	:	610-631-5282

Authorized Official
Title or Position	:	OWNER
Name	:	DR. CATHERINE QUINN-KERINS
Credential	:	PH.D. LLC
Telephone Number	:	610-631-9298

Provider Enumeration Date	:	05/09/2019
Last Update Date	:	10/31/2024

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