Active NPI
Alan Raymond Quinn, PH.D.
- Clinical Psychologist
- Kennett Square, PA
National Provider Identifier
1790847291
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PS002301 L
- Practice address
- 644 E Cypress St
Kennett Square, PA 19348-2447 - Phone
- (610) 444-9665
- Fax
- (610) 444-0584
- NPI assigned
- Dec 14, 2006
- Sex
- Male
- 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 | PS002301 L | PA | Primary |
Addresses
Primary practice location
644 E Cypress St
Kennett Square, PA 19348-2447
Mailing address
644 E Cypress St
P.O. Box 22
Kennett Square, PA 19348-2447
Phone (610) 444-9665
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 18952 | Other | PA | BC BS |
| 4343397 | Other | PA | AETNA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120427000341 | PA | Practitioner - Clinical Psychologist | 9133381783 | Practice locations: Kennett Square, PA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- University of Connecticut School of Medicine, 1975
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
644 E Cypress St
Kennett Square Counseling Center
Kennett Square, PA 19348-0022
Phone (610) 444-9665
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS002301 L | PA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166054400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1790847291",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "644 E CYPRESS ST",
"address_2": "P.O. BOX 22",
"city": "KENNETT SQUARE",
"state": "PA",
"postal_code": "193482447",
"telephone_number": "610-444-9665",
"fax_number": "610-444-0584"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "644 E CYPRESS ST",
"city": "KENNETT SQUARE",
"state": "PA",
"postal_code": "193482447",
"telephone_number": "610-444-9665",
"fax_number": "610-444-0584"
}
],
"practiceLocations": [],
"basic": {
"last_name": "QUINN",
"first_name": "ALAN",
"middle_name": "RAYMOND",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "PA",
"license": "PS002301 L",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC BS",
"identifier": "18952",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4343397",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kennett Square, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.