Individual ProviderTricia EagenCounselorBehavioral Health & Social Service ProvidersPractice Address104 W 4th St Ste 204, Royal Oak, MI 48067-3803(458) 215-1356PECOS EnrollmentBased on the most recent information from CMS, provider Tricia Eagen 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 2 days ago.Profile DetailsProvider ID1093564809Provider TypeIndividualFull NameEagen, TriciaCredentialLPCGenderFemaleSole ProprietorYesEnumeration Date5/14/2024Last Updated5/14/2024Contact InformationPractice LocationPractice Address104 W 4th St Ste 204, Royal Oak, MI 48067-3803Phone(458) 215-1356FaxUnlisted FaxMailing LocationMailing Address1829 W Stadium Blvd Ste 300, Ann Arbor, MI 48103-7009Phone(458) 215-1356FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicense6401223026Michigan