Individual ProviderSandra RobertsCounselorBehavioral Health & Social Service ProvidersPractice Address2134 W Lawrence Ave, Springfield, IL 62704-1417(217) 565-0014PECOS EnrollmentBased on the most recent information from CMS, provider Sandra Roberts 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 ID1417386699Provider TypeIndividualFull NameRoberts, SandraCredentialLCPCGenderFemaleSole ProprietorNoEnumeration Date11/7/2013Last Updated7/21/2023Contact InformationPractice LocationPractice Address2134 W Lawrence Ave, Springfield, IL 62704-1417Phone(217) 565-0014FaxUnlisted FaxMailing LocationMailing Address2134 W Lawrence Ave, Springfield, IL 62704-1417Phone(217) 565-0014FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode101YP2500XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicense180008852IllinoisCode101Y00000XDescriptionCounselorBehavioral Health & Social Service ProvidersLicense180008852IllinoisCode101YM0800XDescriptionCounselorBehavioral Health & Social Service ProvidersLicense180008852IllinoisProvider IdentifiersIDDescriptionIssuerID180008852DescriptionOtherIssuerSTATE LICENSEIllinois