Provider Demographics
NPI:1407991029
Name:TEMELINI, ELEANOR HAGER (MSW LICSW)
Entity Type:Individual
Prefix:MRS
First Name:ELEANOR
Middle Name:HAGER
Last Name:TEMELINI
Suffix:
Gender:F
Credentials:MSW LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 CORNAUBA ST EXT
Mailing Address - Street 2:
Mailing Address - City:ROSLINDALE
Mailing Address - State:MA
Mailing Address - Zip Code:02131
Mailing Address - Country:US
Mailing Address - Phone:617-413-3856
Mailing Address - Fax:617-723-7654
Practice Address - Street 1:15 COURT SQUARE
Practice Address - Street 2:SUITE 830
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02108
Practice Address - Country:US
Practice Address - Phone:617-413-3856
Practice Address - Fax:617-723-7654
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10236801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MATEP23409Medicare ID - Type Unspecified