Provider Demographics
NPI:1316005341
Name:EATON, ANNE L (MSW)
Entity Type:Individual
Prefix:MS
First Name:ANNE
Middle Name:L
Last Name:EATON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 OLD SUDBURY RD
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:MA
Mailing Address - Zip Code:01773-4805
Mailing Address - Country:US
Mailing Address - Phone:781-259-8724
Mailing Address - Fax:
Practice Address - Street 1:8 GROVE ST
Practice Address - Street 2:SUITE 303
Practice Address - City:WELLESLEY
Practice Address - State:MA
Practice Address - Zip Code:02482-7797
Practice Address - Country:US
Practice Address - Phone:781-431-7323
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA106368101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAPO4098OtherBLUE CROSS BLUE SHIELD