Individual ProviderKerry EllisCounselorBehavioral Health & Social Service ProvidersPractice Address190 High St Apt 210, Medford, MA 02155-3810(339) 223-7727PECOS EnrollmentBased on the most recent information from CMS, provider Kerry Ellis 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 ID1649767203Provider TypeIndividualFull NameEllis, KerryGenderFemaleSole ProprietorYesEnumeration Date4/19/2018Last Updated4/19/2018Contact InformationPractice LocationPractice Address190 High St Apt 210, Medford, MA 02155-3810Phone(339) 223-7727FaxUnlisted FaxMailing LocationMailing Address190 High St Apt 210, Medford, MA 02155-3810Phone(339) 223-7727FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer