Individual ProviderKristen Michelle ClowCounselorBehavioral Health & Social Service ProvidersPractice Address3233 Mathers Road Suite A, 62711, IL 62704(217) 414-2064(217) 416-0737PECOS EnrollmentBased on the most recent information from CMS, provider Kristen Michelle Clow 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 ID1770221426Provider TypeIndividualFull NameClow, Kristen MichelleCredentialM.A., LCPCGenderFemaleSole ProprietorYesEnumeration Date5/23/2022Last Updated6/16/2022Contact InformationPractice LocationPractice Address3233 Mathers Road Suite A, 62711, IL 62704Phone(217) 414-2064FaxUnlisted FaxMailing LocationMailing Address1221 W Pine St, Springfield, IL 62704-3548Phone(217) 416-0737FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode101YP2500XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicense180.007516IllinoisCode101YP2500XDescriptionCounselorBehavioral Health & Social Service ProvidersLicense178.005177Code101YP2500XDescriptionCounselorBehavioral Health & Social Service ProvidersLicense178.005177Illinois