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NPI Code Detail

MEDICARE: MS. MARY P QUINLAN LICSW LADC

MEDICARE: MS. MARY P QUINLAN LICSW LADC
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
1101YA0400XAddiction (Substance Use Disorder) Counselor1753MA
21041C0700XClinical Social Worker1022820MA

General Provider Information

NPI Number : 1407846553
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MARY P QUINLAN LICSW LADC
Provider Business Mailing Address
First Line : 45 EASTERN AVE
Second Line :
City : GREENFIELD
State : MA
Zip : 01301-1218
Country : US
Telephone Number : 413-774-1000
Fax Number : 413-774-1197
Provider Business Practice Location Address
First Line : 215 SHELBURNE RD
Second Line :
City : GREENFIELD
State : MA
Zip : 01301-9622
Country : US
Telephone Number : 413-774-1000
Fax Number : 413-774-1197
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/28/2005
Last Update Date : 09/11/2025

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