Individual ProviderSophie Marcelle GliksonCounselorBehavioral Health & Social Service ProvidersPractice Address142 Walsh Street, Medford, MA 02155-1245(781) 874-0709PECOS EnrollmentBased on the most recent information from CMS, provider Sophie Marcelle Glikson 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 ID1659422574Provider TypeIndividualFull NameGlikson, Sophie MarcelleTitleMs.CredentialMASGenderFemaleSole ProprietorNoEnumeration Date1/16/2007Last Updated7/8/2007Contact InformationPractice LocationPractice Address142 Walsh Street, Medford, MA 02155-1245Phone(781) 874-0709Fax(781) 874-0224Mailing LocationMailing Address142 Walsh Street, Medford, MA 02155-1245Phone(781) 874-0709Fax(781) 874-0224Provider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicense3110MassachusettsProvider IdentifiersIDDescriptionIssuerID3110DescriptionOtherIssuerLHHC LICENSE MENTAL HEALTMassachusetts