Healthcare Provider Details

I. General information

NPI: 1922157312
Provider Name (Legal Business Name): DENISE MARIE HEYBROCK LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/09/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3285 N ARLINGTON HEIGHTS RD SUITE 203
ARLINGTON HEIGHTS IL
60004-1564
US

IV. Provider business mailing address

945 E KENILWORTH AVE
PALATINE IL
60074-6466
US

V. Phone/Fax

Practice location:
  • Phone: 847-370-3032
  • Fax:
Mailing address:
  • Phone: 847-370-3032
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: