Ellis Weaver | Watertown, MA • PECOS Search

Ellis Weaver

Counselor

Behavioral Health & Social Service Providers

23 Main St, Watertown, MA 02472-4428

PECOS Enrollment

Based on the most recent information from CMS, provider Ellis Weaver 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 2 days ago.

Profile Details

Provider ID
1508328212
Provider Type
Individual
Full Name
Weaver, Ellis
Credential
LMHC

Gender
Female
Sole Proprietor
Yes
Enumeration Date
4/2/2019
Last Updated
7/29/2024

Contact Information

Practice Location

23 Main St, Watertown, MA 02472-4428

Unlisted Fax

Mailing Location

23 Main St, Watertown, MA 02472-4428

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 101YM0800X Primary	Description Counselor Behavioral Health & Social Service Providers	License 11190 Massachusetts