Individual ProviderJohanna Fuentes-MurilloCounselorBehavioral Health & Social Service ProvidersPractice Address1110 South Ave, Staten Island, NY 10314-3403(347) 273-1290PECOS EnrollmentBased on the most recent information from CMS, provider Johanna Fuentes-Murillo 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 1:08 PM.Profile DetailsProvider ID1710790860Provider TypeIndividualFull NameFuentes-Murillo, JohannaCredentialMS, LACGenderFemaleSole ProprietorNoEnumeration Date1/30/2025Last Updated1/30/2025Contact InformationPractice LocationPractice Address1110 South Ave, Staten Island, NY 10314-3403Phone(347) 273-1290FaxUnlisted FaxMailing LocationMailing Address598 Central Ave Ste 7, Po Box 482, New Providence, NJ 07974PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicense37AC00848500New Jersey