Individual ProviderTara CellettiSocial WorkerBehavioral Health & Social Service ProvidersPractice Address6625 Wagner Way Ste 320, Gig Harbor, WA 98335-8392(253) 858-7056(760) 391-2628PECOS EnrollmentBased on the most recent information from CMS, provider Tara Celletti does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1346815420Provider TypeIndividualFull NameCelletti, TaraCredentialLAICSWGenderFemaleSole ProprietorYesEnumeration Date5/21/2021Last Updated5/21/2021Contact InformationPractice LocationPractice Address6625 Wagner Way Ste 320, Gig Harbor, WA 98335-8392Phone(253) 858-7056FaxUnlisted FaxMailing LocationMailing Address5910 51st Street Ct W, University Place, WA 98467-4119Phone(760) 391-2628FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicenseSC61177679Washington