Individual ProviderKelli O'ConnorCounselorBehavioral Health & Social Service ProvidersPractice Address200 Boston Ave Ste 1925, Medford, MA 02155-4243(617) 869-1324PECOS EnrollmentBased on the most recent information from CMS, provider Kelli O'Connor 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 ID1710733688Provider TypeIndividualFull NameO'Connor, KelliGenderFemaleSole ProprietorNoEnumeration Date4/30/2024Last Updated7/31/2024Contact InformationPractice LocationPractice Address200 Boston Ave Ste 1925, Medford, MA 02155-4243Phone(617) 869-1324FaxUnlisted FaxMailing LocationMailing Address121 Main St Apt 2, Woburn, MA 01801-5644Phone(617) 869-1324FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted IssuerCode1041S0200XDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer