Individual ProviderMimi BeaulieuCounselorBehavioral Health & Social Service ProvidersPractice Address195 S Main St, Cheshire, CT 06410-3171(203) 298-8307PECOS EnrollmentBased on the most recent information from CMS, provider Mimi Beaulieu is legally eligible to order and refer claims for Part B and DME services only.Part BMedicare Part BEnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 4 days ago.Profile DetailsProvider ID1497910343Provider TypeIndividualFull NameBeaulieu, MimiCredentialLPC, CCDPGenderFemaleSole ProprietorYesEnumeration Date7/21/2008Last Updated3/6/2024Contact InformationPractice LocationPractice Address195 S Main St, Cheshire, CT 06410-3171Phone(203) 298-8307FaxUnlisted FaxMailing LocationMailing Address83 Chesterfield Rd, East Lyme, CT 06333-1202Phone(203) 298-8307FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode101YP2500XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicense001709Connecticut