Individual ProviderYvonne GonzalesCounselorBehavioral Health & Social Service ProvidersPractice Address45 Dimock St, Roxbury, MA 02119-1208(617) 442-8800PECOS EnrollmentBased on the most recent information from CMS, provider Yvonne Gonzales 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 ID1487175220Provider TypeIndividualFull NameGonzales, YvonneCredentialLMHCGenderFemaleSole ProprietorNoEnumeration Date7/2/2017Last Updated2/4/2020Contact InformationPractice LocationPractice Address45 Dimock St, Roxbury, MA 02119-1208Phone(617) 442-8800Fax(617) 442-4088Mailing LocationMailing Address55 Dimock St, Roxbury, MA 02119-1029Phone(617) 442-8800Fax(617) 442-4088Provider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicense11532MassachusettsCode101YA0400XDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer