Provider Demographics
NPI:1992558217
Name:HEDDING-HESS, MATTHEW PAUL (LPC)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:PAUL
Last Name:HEDDING-HESS
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:842 S 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:KANKAKEE
Mailing Address - State:IL
Mailing Address - Zip Code:60901-4814
Mailing Address - Country:US
Mailing Address - Phone:815-549-4831
Mailing Address - Fax:
Practice Address - Street 1:265 STEBBINGS CT STE 1
Practice Address - Street 2:
Practice Address - City:BRADLEY
Practice Address - State:IL
Practice Address - Zip Code:60915-1282
Practice Address - Country:US
Practice Address - Phone:815-200-8653
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.017380101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional