Individual ProviderNia-Sue MitchumSocial WorkerBehavioral Health & Social Service ProvidersPractice Address3 Aspen St, Roxbury, MA 02119-2201(617) 427-3312PECOS EnrollmentBased on the most recent information from CMS, provider Nia-Sue Mitchum is legally eligible to order and refer claims for DME services only.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records today at 12:07 PM.Profile DetailsProvider ID1003085432Provider TypeIndividualFull NameMitchum, Nia-SueTitleMs.CredentialLICSWGenderFemaleSole ProprietorYesEnumeration Date2/29/2008Last Updated3/13/2008Contact InformationPractice LocationPractice Address3 Aspen St, Roxbury, MA 02119-2201Phone(617) 427-3312FaxUnlisted FaxMailing LocationMailing Address3 Aspen St, Roxbury, MA 02119-2201Phone(617) 427-3312FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense104143Massachusetts