Provider Demographics
NPI:1245987593
Name:HEARON, PARIS SIMONE (LSW)
Entity type:Individual
Prefix:
First Name:PARIS
Middle Name:SIMONE
Last Name:HEARON
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17757 PAXTON AVE
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:IL
Mailing Address - Zip Code:60438-1572
Mailing Address - Country:US
Mailing Address - Phone:708-351-6918
Mailing Address - Fax:
Practice Address - Street 1:700 N SACRAMENTO BLVD STE 201
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-1058
Practice Address - Country:US
Practice Address - Phone:224-213-1577
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-07
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150.105518104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker