| Carelon Behavioral Care, Inc. | |
|
200 State St Ste 302 Boston MA 02109-2672 | |
| (978) 846-6340 | |
| (888) 733-9280 |
| Full Name | Carelon Behavioral Care, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 200 State St Ste 302, Boston, Massachusetts |
| Authorized Official Name and Position | Angela Edmonds (GENERAL MANAGER) |
| Authorized Official Contact | 8552276562 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Carelon Behavioral Care, Inc. 200 State St Ste 302 Boston MA 02109-2672 Ph: (855) 227-6562 | Carelon Behavioral Care, Inc. 200 State St Ste 302 Boston MA 02109-2672 Ph: (978) 846-6340 |
| NPI Number | 1053894790 |
|---|---|
| Provider Enumeration Date | 09/10/2018 |
| Last Update Date | 09/01/2023 |
| Certification Date | 09/01/2023 |
| Medicare PECOS PAC ID | 6608113477 |
|---|---|
| Medicare Enrollment ID | O20230118002506 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053894790 | NPI | - | NPPES |
| Provider Name | Tricia Mccloskey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023380433 PECOS PAC ID: 9537530159 Enrollment ID: I20230118002588 |
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