Healthcare Provider Details

I. General information

NPI: 1790593978
Provider Name (Legal Business Name): ELIZABETH MARGARET ESTEY LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/20/2024
Last Update Date: 12/20/2024
Certification Date: 12/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 CUMMINGS CTR STE 534G
BEVERLY MA
01915-6239
US

IV. Provider business mailing address

142P CANAL ST
SALEM MA
01970-4650
US

V. Phone/Fax

Practice location:
  • Phone: 978-548-6288
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberLCSW2120342
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: