Individual ProviderDominique Renee StewartCounselorBehavioral Health & Social Service ProvidersPractice Address504 Dudley St, Roxbury, MA 02119-2732(617) 445-6655PECOS EnrollmentBased on the most recent information from CMS, provider Dominique Renee Stewart 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 yesterday at 12:57 PM.Profile DetailsProvider ID1083306922Provider TypeIndividualFull NameStewart, Dominique ReneeGenderFemaleSole ProprietorYesEnumeration Date5/22/2023Last Updated5/22/2023Contact InformationPractice LocationPractice Address504 Dudley St, Roxbury, MA 02119-2732Phone(617) 445-6655FaxUnlisted FaxMailing LocationMailing Address504 Dudley St, Roxbury, MA 02119-2732PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode101Y00000XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted IssuerMassachusettsCode101YM0800XDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer