Individual ProviderVicki L VandeveerCounselorBehavioral Health & Social Service ProvidersPractice Address2659 Farragut Dr, Springfield, IL 62704-1459(217) 726-7273PECOS EnrollmentBased on the most recent information from CMS, provider Vicki L Vandeveer 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 ID1508997875Provider TypeIndividualFull NameVandeveer, Vicki LCredentialMA, LCPC, LMFT, CADCGenderFemaleSole ProprietorYesEnumeration Date3/8/2007Last Updated4/20/2010Contact InformationPractice LocationPractice Address2659 Farragut Dr, Springfield, IL 62704-1459Phone(217) 726-7273FaxUnlisted FaxMailing LocationMailing Address2659 Farragut Dr, Springfield, IL 62704-1459Phone(217) 726-7273FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode101YP2500XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicense180001778IllinoisCode101YA0400XDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted IssuerCode106H00000XDescriptionMarriage & Family TherapistBehavioral Health & Social Service ProvidersLicense16600339Illinois