Healthcare Provider Details

I. General information

NPI: 1629507660
Provider Name (Legal Business Name): HEIMER COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2017
Last Update Date: 08/02/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24012 W RENWICK RD
PLAINFIELD IL
60544-8731
US

IV. Provider business mailing address

24946 CHELSEA LN
PLAINFIELD IL
60544-7156
US

V. Phone/Fax

Practice location:
  • Phone: 815-676-4688
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: NICHOLAS HEIMER
Title or Position: OWNER
Credential: LCPC
Phone: 815-585-0527