Individual ProviderTegan O'NeillSocial WorkerBehavioral Health & Social Service ProvidersPractice Address45 Dimock St, Roxbury, MA 02119-1208(617) 442-8800PECOS EnrollmentBased on the most recent information from CMS, provider Tegan O'Neill 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 today at 12:07 PM.Profile DetailsProvider ID1740785500Provider TypeIndividualFull NameO'Neill, TeganCredentialLICSWGenderFemaleSole ProprietorYesEnumeration Date3/26/2018Last Updated2/17/2022Contact InformationPractice LocationPractice Address45 Dimock St, Roxbury, MA 02119-1208Phone(617) 442-8800Fax(617) 541-8472Mailing LocationMailing Address1949 Commonwealth Ave Apt 24, Brighton, MA 02135-5913PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense124455MassachusettsProvider IdentifiersIDDescriptionIssuerIDUKB983336842DescriptionOtherIssuerBLUE CROSS BLUE SHIELD