Healthcare Provider Details

I. General information

NPI: 1164973590
Provider Name (Legal Business Name): ELSY ESTELLA QUINTERO MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ELSY ESTELLA QUINTERO LMHC

II. Dates (important events)

Enumeration Date: 10/20/2016
Last Update Date: 01/05/2026
Certification Date: 01/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 DUNHAM RD STE 32003350
BEVERLY MA
01915-1882
US

IV. Provider business mailing address

65 DODGE ST UNIT C
BEVERLY MA
01915-1700
US

V. Phone/Fax

Practice location:
  • Phone: 508-475-9711
  • Fax:
Mailing address:
  • Phone: 978-594-2480
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: