Individual ProviderCourtney PackardCounselorBehavioral Health & Social Service ProvidersPractice Address504 Dudley St, Roxbury, MA 02119-2732(617) 445-6655PECOS EnrollmentBased on the most recent information from CMS, provider Courtney Packard 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 ID1558039602Provider TypeIndividualFull NamePackard, CourtneyGenderFemaleSole ProprietorYesEnumeration Date9/2/2021Last Updated8/23/2023Contact InformationPractice LocationPractice Address504 Dudley St, Roxbury, MA 02119-2732Phone(617) 445-6655FaxUnlisted FaxMailing LocationMailing Address504 Dudley St # Ma, Roxbury, MA 02119-2732PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted IssuerCode106S00000XDescriptionBehavior TechnicianBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer