Active NPI
Constance Romer-Quirin, M.S.
- Clinical Psychologist
- Wayne, PA
National Provider Identifier
1053450239
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PS007042L
- Practice address
- 175 Strafford Ave., Suite 1
Suite 17, Ironwood Business Center
Wayne, PA 19087-1908 - Phone
- (215) 489-8640
- Fax
- (215) 489-8642
- NPI assigned
- Feb 5, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PS007042L | PA | Primary |
Addresses
Primary practice location
175 Strafford Ave., Suite 1
Suite 17, Ironwood Business Center
Wayne, PA 19087-1908
Mailing address
175 Strafford Ave Ste 1
Wayne, PA 19087-3340
Phone (215) 489-8640
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS007042L | PA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1614729600000",
"number": "1053450239",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "175 STRAFFORD AVE STE 1",
"city": "WAYNE",
"state": "PA",
"postal_code": "190873340",
"telephone_number": "215-489-8640",
"fax_number": "215-489-8642"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "175 STRAFFORD AVE., SUITE 1",
"address_2": "SUITE 17, IRONWOOD BUSINESS CENTER",
"city": "WAYNE",
"state": "PA",
"postal_code": "190871908",
"telephone_number": "215-489-8640",
"fax_number": "215-489-8642"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROMER-QUIRIN",
"first_name": "CONSTANCE",
"name_prefix": "Mrs.",
"credential": "M.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-05",
"last_updated": "2021-03-03",
"certification_date": "2021-02-12",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "PA",
"license": "PS007042L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wayne, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.