| Organization Name: | HEART LIGHT PSYCHOLOGICAL SERVICES |
| NPI Number: | 1003932039 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | PAUL EDWARD NEVIN (PRESIDENT) |
| Mailing Address: | 747 Lake Cook Rd Ste 105w Deerfield |
| State: | IL US |
| Postal Code: | 600154935 |
| Phone Number: | 8472055698 |
| Fax Number: | |
| NPI Enumeration Date: | 03/21/2007 |
| NPI Last Update Date: | 10/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |