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General NPI Number Information
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NPI Number | 1639438211
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Entity Type | Organization
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Legal Business Name | HEURISTIC HEALING HUMANITY
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Dates
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Enumeration Date | 05/16/2012
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Last Update Date | 05/16/2012
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Provider Practice Location Address
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Address Line | 9453 S. ASHLAND AVE SUITE 3
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City | CHICAGO
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State | IL
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Zip | 60620-5105
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Country | US
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Telephone | 773-238-5555
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Fax | 773-238-5533
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Provider Business Mailing Address
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Address Line | 1708 W BEVERLY GLEN PKWY
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City | CHICAGO
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State | IL
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Zip | 60643-2127
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Country | US
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Telephone | 773-405-1035
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Fax | 773-238-5533
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Authorized Official
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Title or Position | PARTNER
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Name | MRS. PAULETTE R EASON-WILLIAMS
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Credential | LCPC CADC
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Telephone | 773-405-1035
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 13958
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 178-007097
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 180-005158
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License Number State | IL
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