Individual ProviderJocelyn Ruby Peacock-JohnsonCounselorBehavioral Health & Social Service ProvidersPractice Address10373 NE Hancock St Ste 200, Portland, OR 97220-3873(503) 261-6155(503) 522-9123PECOS EnrollmentBased on the most recent information from CMS, provider Jocelyn Ruby Peacock-Johnson 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 ID1881713972Provider TypeIndividualFull NamePeacock-Johnson, Jocelyn RubyCredentialBSGenderFemaleSole ProprietorNoEnumeration Date3/28/2007Last Updated6/3/2008Contact InformationPractice LocationPractice Address10373 NE Hancock St Ste 200, Portland, OR 97220-3873Phone(503) 261-6155Fax(503) 253-8020Mailing LocationMailing Address6311 White Tail Dr Apt 55, West Linn, OR 97068-2571Phone(503) 522-9123FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted IssuerCode101YA0400XDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted IssuerCode171M00000XDescriptionCase Manager/Care CoordinatorOther Service ProvidersLicenseUnlisted Issuer