Provider Demographics
NPI:1639438211
Name:HEURISTIC HEALING HUMANITY
Entity Type:Organization
Organization Name:HEURISTIC HEALING HUMANITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAULETTE
Authorized Official - Middle Name:R
Authorized Official - Last Name:EASON-WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC CADC
Authorized Official - Phone:773-405-1035
Mailing Address - Street 1:1708 W BEVERLY GLEN PKWY
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60643-2127
Mailing Address - Country:US
Mailing Address - Phone:773-405-1035
Mailing Address - Fax:773-238-5533
Practice Address - Street 1:9453 S. ASHLAND AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60620-5105
Practice Address - Country:US
Practice Address - Phone:773-238-5555
Practice Address - Fax:773-238-5533
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-16
Last Update Date:2012-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL13958101YA0400X
IL180-005158101YP2500X
IL178-007097101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty