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Eileen Tara Crehan

Counselor

Behavioral Health & Social Service Providers

44 Bower St Unit 1, Medford, MA 02155-3662

PECOS Enrollment

Based on the most recent information from CMS, provider Eileen Tara Crehan 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 today at 10:04 AM.

Profile Details

Provider ID
1487228912
Provider Type
Individual
Full Name
Crehan, Eileen Tara
Title
Dr.
Credential
PHD

Gender
Female
Sole Proprietor
Yes
Enumeration Date
5/19/2021
Last Updated
5/19/2021

Contact Information

Practice Location

44 Bower St Unit 1, Medford, MA 02155-3662

(508) 446-7248

Unlisted Fax

Mailing Location

44 Bower St Unit 1, Medford, MA 02155-3662

(508) 446-7248

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 101YM0800X Primary	Description Counselor Behavioral Health & Social Service Providers	License Unlisted Issuer
Code 103TC0700X	Description Psychologist Behavioral Health & Social Service Providers	License TBD Massachusetts
Code 103TM1800X	Description Psychologist Behavioral Health & Social Service Providers	License Unlisted Issuer

Eileen Tara Crehan

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

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