Provider Demographics
NPI:1447347182
Name:QUINTERNO, ROBIN (LICSW)
Entity type:Individual
Prefix:MRS
First Name:ROBIN
Middle Name:
Last Name:QUINTERNO
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:MS
Other - First Name:ROBIN
Other - Middle Name:M
Other - Last Name:BRANCO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:386 STANLEY ST
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02720-6009
Mailing Address - Country:US
Mailing Address - Phone:508-675-1054
Mailing Address - Fax:508-324-7777
Practice Address - Street 1:386 STANLEY ST
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720-6009
Practice Address - Country:US
Practice Address - Phone:508-675-1054
Practice Address - Fax:508-324-7777
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2015-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10287571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP22376-01Medicare PIN