Individual ProviderJudith W SemonoffSocial WorkerBehavioral Health & Social Service ProvidersPractice Address1430 Main St, Waltham, MA 02451-1623(781) 647-5327(401) 339-4560PECOS EnrollmentBased on the most recent information from CMS, provider Judith W Semonoff 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 today at 10:04 AM.Profile DetailsProvider ID1295751881Provider TypeIndividualFull NameSemonoff, Judith WCredentialLICSWGenderFemaleSole ProprietorNoEnumeration Date7/15/2006Last Updated3/20/2018Contact InformationPractice LocationPractice Address1430 Main St, Waltham, MA 02451-1623Phone(781) 647-5327FaxUnlisted FaxMailing LocationMailing Address33 Hilltop Ave, Barrington, RI 02806-3515Phone(401) 339-4560FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicenseISW01351Rhode IslandCode1041C0700XDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense115688MassachusettsProvider IdentifiersIDDescriptionIssuerID6400144DescriptionOtherIssuerEI UHPRhode IslandID292177DescriptionOtherIssuerEI BCROSSRhode IslandID412296DescriptionOtherIssuerEI BCHIPRhode IslandID2092DescriptionOtherIssuerEI NHPRCRhode IslandIDES01788DescriptionMedicaidIssuerUnlistedRhode Island