Individual ProviderPhyllis Mccolister-CunninghamCounselorBehavioral Health & Social Service ProvidersPractice Address900 Virginia Ave Ste 7, Fort Pierce, FL 34982-5882(772) 448-4189PECOS EnrollmentBased on the most recent information from CMS, provider Phyllis Mccolister-Cunningham is legally eligible to order and refer claims for Part B and DME services only.Part BMedicare Part BEnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1760891121Provider TypeIndividualFull NameMccolister-Cunningham, PhyllisTitleMrs.CredentialM.S., LMHC, CAPGenderFemaleSole ProprietorYesEnumeration Date8/10/2014Last Updated12/5/2023Contact InformationPractice LocationPractice Address900 Virginia Ave Ste 7, Fort Pierce, FL 34982-5882Phone(772) 448-4189Fax(772) 245-4259Mailing LocationMailing Address900 Virginia Ave Ste 7, Fort Pierce, FL 34982-5882Phone(772) 448-4189Fax(772) 245-4259Provider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseMH14456FloridaCode101YM0800XDescriptionCounselorBehavioral Health & Social Service ProvidersLicense650789152FloridaCode101YM0800XDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted IssuerProvider IdentifiersIDDescriptionIssuerID650789152DescriptionOtherIssuerSUNCOASTFlorida