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John Eagle

Social Worker

Behavioral Health & Social Service Providers

3283 122nd Ave., Allegan, MI 49010

(269) 673-5854 (269) 673-6617

PECOS Enrollment

Based on the most recent information from CMS, provider John Eagle does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 4 days ago.

Profile Details

Provider ID
1306223359
Provider Type
Individual
Full Name
Eagle, John
Credential
LMSW

Gender
Male
Sole Proprietor
No
Enumeration Date
4/29/2015
Last Updated
3/29/2023

Contact Information

Practice Location

3283 122nd Ave., Allegan, MI 49010

(269) 673-5854

Unlisted Fax

Mailing Location

3283 122nd Ave, Allegan, MI 49010-9511

(269) 673-6617

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License 6801116117 Michigan
Code 104100000X	Description Social Worker Behavioral Health & Social Service Providers	License 6802082302 Michigan

John Eagle

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Kelly, Morgan

Klay, Leigh Ann

Green, David M

Segar, Stephanie

Weld, Larissa

Thomas, Joshua David

Oliva, Angela

Sparks, Kenneth John

Christina Hamman Therapy Llc

Varice, Elondra