Shaun Edward Heitzman, LCPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

178.013894 Issued in IL

Practice address

28W671 Garys Mill Rd
Winfield, IL 60190-1564

Phone

(630) 293-9860

NPI assigned

Feb 12, 2020

Last updated

Feb 10, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pathways Psychology Services P.C.

  • Clinical Psychologist
  • Winfield, IL
  • NPI 1942485198
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1581465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644451200000",
    "number": "1790317295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28W671 GARYS MILL RD",
            "city": "WINFIELD",
            "state": "IL",
            "postal_code": "601901564",
            "telephone_number": "630-293-9860",
            "fax_number": "630-293-9861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28W671 GARYS MILL RD",
            "city": "WINFIELD",
            "state": "IL",
            "postal_code": "601901564",
            "telephone_number": "630-293-9860"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3933 75th St Ste 102",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "IL",
            "postal_code": "605048015",
            "country_code": "US",
            "telephone_number": "630-293-9860",
            "fax_number": "630-293-9861",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEITZMAN",
        "first_name": "SHAUN",
        "middle_name": "EDWARD",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-12",
        "last_updated": "2022-02-10",
        "certification_date": "2022-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178.013894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hearing Professionals of America LLC
• Heartwood Counseling & Wellness PLLC
• Benjamin Thomas Heatwole, M.D.
• Steven Thomas Heidt, MD
• Jennifer N Heise, APN
• Diana Constanza Hengartner, M.D.
• Erin Marie Heniff, AU.D.
• Julia Kochel Hernandez, M.D.
• David Hilburn
• Natalie Bailey Hill, AG-ACNP, BC

• Professional Counselor in Winfield, IL
• Providers in Winfield, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.