Individual ProviderAnnette S MallenCounselorBehavioral Health & Social Service ProvidersPractice Address151 Mystic Ave, Medford, MA 02155-4632(781) 396-1199(508) 942-1103PECOS EnrollmentBased on the most recent information from CMS, provider Annette S Mallen 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 yesterday at 10:04 AM.Profile DetailsProvider ID1407947989Provider TypeIndividualFull NameMallen, Annette SCredentialLCSWGenderFemaleSole ProprietorNoEnumeration Date9/27/2006Last Updated7/8/2007Contact InformationPractice LocationPractice Address151 Mystic Ave, Medford, MA 02155-4632Phone(781) 396-1199Fax(781) 396-1439Mailing LocationMailing Address5 High St, South Dartmouth, MA 02748-3808Phone(508) 942-1103Fax(781) 396-1439Provider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicense207323Massachusetts