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NPI Code Detail

MEDICARE: CAROLYN QUINN LCSW

MEDICARE: CAROLYN QUINN LCSW
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
1101YM0800XMental Health CounselorLCSW72497CA

General Provider Information

NPI Number : 1538457924
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAROLYN QUINN LCSW
Provider Business Mailing Address
First Line : PO BOX 10882
Second Line :
City : BURBANK
State : CA
Zip : 91510-0882
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7150 TAMPA AVE
Second Line :
City : RESEDA
State : CA
Zip : 91335-3700
Country : US
Telephone Number : 818-774-8444
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/19/2011
Last Update Date : 02/06/2026

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