Provider Demographics
NPI:1417323668
Name:HEYING, LINDA M (PSY D)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:M
Last Name:HEYING
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:M
Other - Last Name:MANTERNACH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:151 N KENILWORTH AVE APT 2G
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60301-1220
Mailing Address - Country:US
Mailing Address - Phone:563-543-8920
Mailing Address - Fax:
Practice Address - Street 1:151 N KENILWORTH AVE APT 2G
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60301-1220
Practice Address - Country:US
Practice Address - Phone:563-543-8920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-11
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL208-000380106H00000X
IL166001076106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist