Individual ProviderKristina Marie NicholsCounselorBehavioral Health & Social Service ProvidersPractice Address151 Mystic Ave, Suite Six, Medford, MA 02155-4632(781) 396-1199PECOS EnrollmentBased on the most recent information from CMS, provider Kristina Marie Nichols 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 ID1346488145Provider TypeIndividualFull NameNichols, Kristina MarieCredentialMHCGenderFemaleSole ProprietorYesEnumeration Date2/2/2009Last Updated2/2/2009Contact InformationPractice LocationPractice Address151 Mystic Ave, Suite Six, Medford, MA 02155-4632Phone(781) 396-1199Fax(781) 396-1439Mailing LocationMailing Address151 Mystic Ave, Suite Six, Medford, MA 02155-4632Phone(781) 396-1199Fax(781) 396-1439Provider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer