Individual ProviderSophia TerrySocial WorkerBehavioral Health & Social Service ProvidersPractice Address1430 Main St, Waltham, MA 02451-1623(781) 697-0474PECOS EnrollmentBased on the most recent information from CMS, provider Sophia Terry 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 10:04 AM.Profile DetailsProvider ID1104456821Provider TypeIndividualFull NameTerry, SophiaGenderFemaleSole ProprietorNoEnumeration Date1/22/2020Last Updated1/22/2020Contact InformationPractice LocationPractice Address1430 Main St, Waltham, MA 02451-1623Phone(781) 697-0474FaxUnlisted FaxMailing LocationMailing Address15 Pearl St Unit 2, Belmont, MA 02478-1924PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense222261Massachusetts