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Organization
SUMMIT PSYCHOTHERAPY
Active
Organization
SUMMIT PSYCHOTHERAPY
Active
Other names
Summit Psychotherapy, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ERICH H HEINTZEN IV LCSW (PSYCHOTHERAPIST)
(773) 612-6206
Entity
Organization
Contact information
Practice address
4753 N BROADWAY ST STE 1014, CHICAGO, IL 60640-4990
(773) 612-6206
Mailing address
5842 N WAYNE AVE APT G, CHICAGO, IL 60660-1981
(773) 612-6206
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
11/08/2019
Last updated
09/23/2021
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