Paul Michael Johnson | Medford, MA • PECOS Search

Paul Michael Johnson

Counselor

Behavioral Health & Social Service Providers

151 Mystic Ave, Medford, MA 02155-4632

(781) 396-1199 (617) 455-8424

PECOS Enrollment

Based on the most recent information from CMS, provider Paul Michael Johnson does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 10:04 AM.

Profile Details

Provider ID
1912463811
Provider Type
Individual
Full Name
Johnson, Paul Michael
Title
Mr.

Gender
Male
Sole Proprietor
Yes
Enumeration Date
2/15/2019
Last Updated
2/15/2019

Contact Information

Practice Location

151 Mystic Ave, Medford, MA 02155-4632

Unlisted Fax

Mailing Location

52 Montgomery St Apt 3, Cambridge, MA 02140-2436

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 101YM0800X Primary	Description Counselor Behavioral Health & Social Service Providers	License Unlisted Issuer