Active NPI
Colleen Quinn, PSY.D.
- Clinical Psychologist
- Fayetteville, NC
National Provider Identifier
1255627717
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 4078
- Practice address
- 200 Mason St
2ND Floor
Fayetteville, NC 28301-5041 - Phone
- (910) 437-2517
- Fax
- (910) 437-2520
- NPI assigned
- Jun 23, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 4078 | NC | Primary |
| Intellectual & Developmental Disabilities Psychologist | 103TM1800X | 4078 | NC |
Addresses
Primary practice location
200 Mason St
2ND Floor
Fayetteville, NC 28301-5041
Mailing address
200 Mason St
2ND Floor
Fayetteville, NC 28301-5041
Phone (910) 437-2517
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4078 | NC | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1308787200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1308787200000",
"number": "1255627717",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 MASON ST",
"address_2": "2ND FLOOR",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283015041",
"telephone_number": "910-437-2517",
"fax_number": "910-437-2520"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 MASON ST",
"address_2": "2ND FLOOR",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283015041",
"telephone_number": "910-437-2517",
"fax_number": "910-437-2520"
}
],
"practiceLocations": [],
"basic": {
"last_name": "QUINN",
"first_name": "COLLEEN",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-06-23",
"last_updated": "2011-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NC",
"license": "4078",
"primary": true
},
{
"code": "103TM1800X",
"taxonomy_group": "",
"desc": "Psychologist, Intellectual & Developmental Disabilities",
"state": "NC",
"license": "4078",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.