Individual ProviderDouglas BentonCounselorBehavioral Health & Social Service ProvidersPractice Address520 Dudley St, Roxbury, MA 02119-2769(617) 602-7869PECOS EnrollmentBased on the most recent information from CMS, provider Douglas Benton 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 2 days ago.Profile DetailsProvider ID1013244672Provider TypeIndividualFull NameBenton, DouglasGenderMaleSole ProprietorNoEnumeration Date11/3/2009Last Updated11/3/2009Contact InformationPractice LocationPractice Address520 Dudley St, Roxbury, MA 02119-2769Phone(617) 602-7869Fax(617) 541-8178Mailing LocationMailing Address520 Dudley St, Roxbury, MA 02119-2769Phone(617) 602-7869Fax(617) 541-8178Provider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer