Individual ProviderNike Konstantina GregoryCounselorBehavioral Health & Social Service ProvidersPractice Address42 Thomas St, Medford, MA 02155-4536(978) 476-3708PECOS EnrollmentBased on the most recent information from CMS, provider Nike Konstantina Gregory 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 ID1376867556Provider TypeIndividualFull NameGregory, Nike KonstantinaTitleMissCredentialLICSWGenderFemaleSole ProprietorYesEnumeration Date3/17/2010Last Updated3/9/2022Contact InformationPractice LocationPractice Address42 Thomas St, Medford, MA 02155-4536Phone(978) 476-3708FaxUnlisted FaxMailing LocationMailing Address42 Thomas St, Medford, MA 02155-4536Phone(978) 476-3708FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted IssuerCode1041C0700XDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense123330Massachusetts