Individual ProviderSara Ines BonillaCounselorBehavioral Health & Social Service ProvidersPractice Address10 Cabot Rd Ste 205, Medford, MA 02155-5173(781) 202-6524(781) 816-3130PECOS EnrollmentBased on the most recent information from CMS, provider Sara Ines Bonilla 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 ID1902956089Provider TypeIndividualFull NameBonilla, Sara InesTitleMs.CredentialLMHC, CCMGenderFemaleSole ProprietorNoEnumeration Date1/11/2007Last Updated12/16/2024Contact InformationPractice LocationPractice Address10 Cabot Rd Ste 205, Medford, MA 02155-5173Phone(781) 202-6524FaxUnlisted FaxMailing LocationMailing Address22 9th St Apt 104, Medford, MA 02155-5139Phone(781) 816-3130FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseLMHC7737MassachusettsCode171M00000XDescriptionCase Manager/Care CoordinatorOther Service ProvidersLicenseCCM4242685Massachusetts