Individual ProviderJungkeun KimCounselorBehavioral Health & Social Service ProvidersPractice Address17 Greenville St, Roxbury, MA 02119-2315(617) 783-8035PECOS EnrollmentBased on the most recent information from CMS, provider Jungkeun Kim 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 ID1588181895Provider TypeIndividualFull NameKim, JungkeunGenderMaleSole ProprietorNoEnumeration Date8/28/2017Last Updated8/28/2017Contact InformationPractice LocationPractice Address17 Greenville St, Roxbury, MA 02119-2315Phone(617) 783-8035FaxUnlisted FaxMailing LocationMailing Address72 Gore St Apt 1, Cambridge, MA 02141-1236PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer