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General NPI Number Information
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NPI Number | 1619480415
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Entity Type | Organization
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Legal Business Name | HEART MIND METHOD, INC
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Dates
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Enumeration Date | 11/15/2017
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Last Update Date | 06/03/2025
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Provider Practice Location Address
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Address Line | 1319 BUTTERFIELD RD STE 500
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City | DOWNERS GROVE
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State | IL
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Zip | 60515-5621
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Country | US
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Telephone | 773-295-7072
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Fax | 312-312-5180
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Provider Business Mailing Address
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Address Line | 800 ROOSEVELT RD BUILDING E, SUITE 220
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City | GLEN ELLYN
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State | IL
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Zip | 60137
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Country | US
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Telephone | 773-295-7072
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JOHN LAWRENCE JAUCH
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Credential | MA, LCPC
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Telephone | 773-295-7072
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 180008827
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License Number State | IL
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