Individual ProviderTami Mcdaniel MossmanCounselorBehavioral Health & Social Service ProvidersPractice Address801 S Grand Ave W, Springfield, IL 62704-3640(217) 502-9120(217) 793-8338PECOS EnrollmentBased on the most recent information from CMS, provider Tami Mcdaniel Mossman 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 ID1396783866Provider TypeIndividualFull NameMcdaniel Mossman, TamiCredentialLCPC, CADCGenderFemaleSole ProprietorYesEnumeration Date6/4/2006Last Updated10/2/2007Contact InformationPractice LocationPractice Address801 S Grand Ave W, Springfield, IL 62704-3640Phone(217) 502-9120FaxUnlisted FaxMailing LocationMailing Address1217 Larchmont Dr, Springfield, IL 62704-2109Phone(217) 793-8338FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode101YP2500XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicense180004510IllinoisCode101YA0400XDescriptionCounselorBehavioral Health & Social Service ProvidersLicense13042Illinois