MEDICARE: MATTHEW PAUL HEDDING-HESS LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	178.017380	IL

General Provider Information

NPI Number	:	1992558217
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW PAUL HEDDING-HESS LPC

Provider Business Mailing Address
First Line	:	842 S 5TH AVE
Second Line	:
City	:	KANKAKEE
State	:	IL
Zip	:	60901-4814
Country	:	US
Telephone Number	:	815-549-4831
Fax Number	:

Provider Business Practice Location Address
First Line	:	265 STEBBINGS CT STE 1
Second Line	:
City	:	BRADLEY
State	:	IL
Zip	:	60915-1282
Country	:	US
Telephone Number	:	815-200-8653
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/08/2024
Last Update Date	:	04/08/2024

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