Individual ProviderMax Verly EtienneCounselorBehavioral Health & Social Service ProvidersPractice Address504 Dudley St, Roxbury, MA 02119-2732(857) 919-7922PECOS EnrollmentBased on the most recent information from CMS, provider Max Verly Etienne 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 ID1528798824Provider TypeIndividualFull NameEtienne, Max VerlyGenderMaleSole ProprietorYesEnumeration Date6/10/2022Last Updated6/10/2022Contact InformationPractice LocationPractice Address504 Dudley St, Roxbury, MA 02119-2732Phone(857) 919-7922FaxUnlisted FaxMailing LocationMailing Address504 Dudley St, Roxbury, MA 02119-2732Phone(857) 919-7922FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode101Y00000XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer