Individual ProviderCarly Michelle JohnsonCounselorBehavioral Health & Social Service ProvidersPractice Address1115 Broadway Fl 11, New York, NY 10010-0058(916) 764-4571PECOS EnrollmentBased on the most recent information from CMS, provider Carly Michelle Johnson 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 today at 9:42 AM.Profile DetailsProvider ID1427856327Provider TypeIndividualFull NameJohnson, Carly MichelleGenderFemaleSole ProprietorYesEnumeration Date3/5/2025Last Updated3/5/2025Contact InformationPractice LocationPractice Address1115 Broadway Fl 11, New York, NY 10010-0058Phone(916) 764-4571FaxUnlisted FaxMailing LocationMailing Address450 Suydam St Apt 2r, Brooklyn, NY 11237-3484Phone(916) 764-4571FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer