Individual ProviderElyse NissimSocial WorkerBehavioral Health & Social Service ProvidersPractice Address3506 Gwynnbrook Ave, Owings Mills, MD 21117-1409(410) 843-7498PECOS EnrollmentBased on the most recent information from CMS, provider Elyse Nissim 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 yesterday at 10:04 AM.Profile DetailsProvider ID1912937319Provider TypeIndividualFull NameNissim, ElyseCredentialLCSW-CGenderFemaleSole ProprietorNoEnumeration Date7/3/2006Last Updated5/13/2013Contact InformationPractice LocationPractice Address3506 Gwynnbrook Ave, Owings Mills, MD 21117-1409Phone(410) 843-7498Fax(410) 664-0115Mailing LocationMailing Address3506 Gwynnbrook Ave, Owings Mills, MD 21117-1409Phone(410) 843-7498Fax(410) 664-0115Provider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense05082Maryland