Individual ProviderJennifer LishPsychologistBehavioral Health & Social Service ProvidersPractice Address9 Cedar St, Worcester, MA 01609-2505(508) 210-0114PECOS EnrollmentBased on the most recent information from CMS, provider Jennifer Lish is legally eligible to order and refer claims for Part B and DME services only.Part BMedicare Part BEnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1265597918Provider TypeIndividualFull NameLish, JenniferCredentialPH.D.GenderFemaleSole ProprietorYesEnumeration Date12/23/2006Last Updated7/8/2007Contact InformationPractice LocationPractice Address9 Cedar St, Worcester, MA 01609-2505Phone(508) 210-0114Fax(508) 755-8645Mailing LocationMailing Address15 Avery Rd, Holden, MA 01520-1235Phone(508) 210-0114Fax(508) 755-8645Provider TaxonomiesCodeDescriptionLicenseCode103TC0700XPrimaryDescriptionPsychologistBehavioral Health & Social Service ProvidersLicense7335MassachusettsProvider IdentifiersIDDescriptionIssuerID1854062DescriptionMedicaidIssuerUnlistedMassachusetts