Individual ProviderEmma SullivanCounselorBehavioral Health & Social Service ProvidersPractice Address504 Dudley St, Roxbury, MA 02119-2732(617) 445-6655PECOS EnrollmentBased on the most recent information from CMS, provider Emma Sullivan 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 ID1043943277Provider TypeIndividualFull NameSullivan, EmmaGenderFemaleSole ProprietorYesEnumeration Date7/6/2022Last Updated7/6/2022Contact InformationPractice LocationPractice Address504 Dudley St, Roxbury, MA 02119-2732Phone(617) 445-6655FaxUnlisted FaxMailing LocationMailing Address504 Dudley St, Roxbury, MA 02119-2732PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer