Individual ProviderPatrick G JohnsonCounselorBehavioral Health & Social Service ProvidersPractice Address151 Mystic Ave Ste 6, Medford, MA 02155-4632(213) 446-9212(339) 298-8406PECOS EnrollmentBased on the most recent information from CMS, provider Patrick G 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 yesterday at 10:04 AM.Profile DetailsProvider ID1295561728Provider TypeIndividualFull NameJohnson, Patrick GGenderMaleSole ProprietorYesEnumeration Date9/11/2024Last Updated10/30/2024Contact InformationPractice LocationPractice Address151 Mystic Ave Ste 6, Medford, MA 02155-4632Phone(213) 446-9212FaxUnlisted FaxMailing LocationMailing Address151 Mystic Ave, #6, Medford, MA 02155Phone(339) 298-8406FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer