Look up the most recent NPI and PECOS records

Kevin Wicker

Counselor

Behavioral Health & Social Service Providers

PECOS Enrollment

Based on the most recent information from CMS, provider Kevin Wicker is legally eligible to order and refer claims for Part B and DME services only.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1124183116
Provider Type
Individual
Full Name
Wicker, Kevin
Credential
LMHC

Gender
Male
Sole Proprietor
Yes
Enumeration Date
12/27/2006
Last Updated
7/8/2007

Contact Information

Practice Location

8 Bennett Rd, Watertown, MA 02472-3133

(617) 926-2638

Unlisted Fax

Mailing Location

8 Bennett Rd, Watertown, MA 02472-3133

(617) 926-2638

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 101YM0800X Primary	Description Counselor Behavioral Health & Social Service Providers	License 5171 Massachusetts

Kevin Wicker

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Snyder, Todd

Bloom, Joyce E

Hirshberg, Alex

Goldsmith, Samantha

Boucher, Suzanne M

Crawford, Amelia

Sowelu Counseling Inc

Handley, Julie A.

Lee, Madeline Jackson

Sajjad, Neha