Individual ProviderDebra Louise BlumthalCounselorBehavioral Health & Social Service ProvidersPractice Address215 S Grand Ave W, Springfield, IL 62704-3838(217) 744-3525PECOS EnrollmentBased on the most recent information from CMS, provider Debra Louise Blumthal 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 12:57 PM.Profile DetailsProvider ID1063541308Provider TypeIndividualFull NameBlumthal, Debra LouiseCredentialNCC, LCPCGenderFemaleSole ProprietorYesEnumeration Date3/4/2007Last Updated7/31/2015Contact InformationPractice LocationPractice Address215 S Grand Ave W, Springfield, IL 62704-3838Phone(217) 744-3525Fax(217) 744-2525Mailing LocationMailing Address215 S Grand Ave W, Springfield, IL 62704-3838Phone(217) 744-3525Fax(217) 744-2525Provider TaxonomiesCodeDescriptionLicenseCode101YP2500XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicense180006218IllinoisProvider IdentifiersIDDescriptionIssuerID180.006218DescriptionOtherIssuerSTATE LICENSE NUMBER-LCPCIllinois