Provider Demographics
NPI:1730221045
Name:QUINN, JANICE ANN (PHD, LCSW)
Entity type:Individual
Prefix:DR
First Name:JANICE
Middle Name:ANN
Last Name:QUINN
Suffix:
Gender:F
Credentials:PHD, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1005 16TH ST S
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22202-1621
Mailing Address - Country:US
Mailing Address - Phone:703-521-1848
Mailing Address - Fax:703-521-1848
Practice Address - Street 1:1005 16TH ST S
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22202-1621
Practice Address - Country:US
Practice Address - Phone:703-521-1848
Practice Address - Fax:703-521-1848
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040029971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA490464Medicare ID - Type Unspecified