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NPI Code Detail

MEDICARE: MR. QUINLAN KELLY

MEDICARE: MR. QUINLAN KELLY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker

General Provider Information

NPI Number : 1669315446
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. QUINLAN KELLY
Provider Business Mailing Address
First Line : 800 CUMMINGS CTR STE 266T
Second Line :
City : BEVERLY
State : MA
Zip : 01915-6172
Country : US
Telephone Number : 978-921-1190
Fax Number :
Provider Business Practice Location Address
First Line : 800 CUMMINGS CTR STE 266T
Second Line :
City : BEVERLY
State : MA
Zip : 01915-6172
Country : US
Telephone Number : 978-921-1190
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/14/2026
Last Update Date : 04/14/2026

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Directions to “ MR. QUINLAN KELLY ” Practice Location

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