Provider Demographics
NPI:1780788281
Name:EYAL, CARMELA (LICSW)
Entity type:Individual
Prefix:
First Name:CARMELA
Middle Name:
Last Name:EYAL
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 ACTON RD
Mailing Address - Street 2:SUITE 25
Mailing Address - City:CHELMSFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01824-3498
Mailing Address - Country:US
Mailing Address - Phone:978-256-6579
Mailing Address - Fax:978-256-1943
Practice Address - Street 1:9 ACTON RD
Practice Address - Street 2:SUITE 25
Practice Address - City:CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01824-3498
Practice Address - Country:US
Practice Address - Phone:978-256-6579
Practice Address - Fax:978-256-1943
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1017608101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1036661OtherCIGNA
MA333113OtherMHN
MAP05245OtherBCBSMA
MA0022320OtherNHP
MA043476807-11OtherPACIFICARE
MA798605OtherTUFTS
MA109912OtherGREAT WEST
NH14Y001004MA01OtherBCBSNH
MA1858351Medicaid
MA1011970OtherFALLON
MA333113OtherMHN