Individual ProviderGladys Nakungu KasansulaCounselorBehavioral Health & Social Service ProvidersPractice AddressSquare Medical Group, 124 Watertown Street, Suite 2d, Watertown, MA 02472(617) 916-5069(617) 407-9385PECOS EnrollmentBased on the most recent information from CMS, provider Gladys Nakungu Kasansula 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 2 days ago.Profile DetailsProvider ID1548735327Provider TypeIndividualFull NameKasansula, Gladys NakunguGenderFemaleSole ProprietorYesEnumeration Date10/9/2018Last Updated10/9/2018Contact InformationPractice LocationPractice AddressSquare Medical Group, 124 Watertown Street, Suite 2d, Watertown, MA 02472Phone(617) 916-5069FaxUnlisted FaxMailing LocationMailing Address24 Whites Ave Apt 27, Watertown, MA 02472-4323Phone(617) 407-9385FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer