Provider Demographics
NPI:1164973590
Name:QUINTERO, ELSY ESTELLA (MS)
Entity Type:Individual
Prefix:
First Name:ELSY
Middle Name:ESTELLA
Last Name:QUINTERO
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:ELSY
Other - Middle Name:ESTELLA
Other - Last Name:WHITNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:439 SOUTH UNION STREET, SUITE 104 HERITAGE BUILDING 2
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01843
Mailing Address - Country:US
Mailing Address - Phone:978-648-8515
Mailing Address - Fax:339-440-4483
Practice Address - Street 1:76 WINTER ST
Practice Address - Street 2:
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01830-5760
Practice Address - Country:US
Practice Address - Phone:978-373-1181
Practice Address - Fax:978-374-7605
Is Sole Proprietor?:No
Enumeration Date:2016-10-20
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health