NICOLE HEFFRON, LLC


Address: 889 Grand Ave, Suite 202, Saint Paul, MN 55105-3008
Phone: 6512241541

NICOLE HEFFRON, LLC (NPI# 1639307622) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1639307622
Entity Type Organization
Organization Name NICOLE HEFFRON, LLC
Practice Address 889 Grand Ave
Suite 202
Saint Paul
MN 55105-3008
Practice Telephone 6512241541
Practice Fax Number 6512243501
Mailing Telephone 6512241541
Mailing Fax Number 6512243501
Enumeration Date 2009-06-29
Last Update Date 2009-06-29
Authorized Official Name MS. NICOLE ENGLUND HEFFRON (LICENSED PSYCHOLOGIST)
Authorized Official Telephone 6512241541
Authorized Official Credential PH.D.
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103TC0700X Psychologist
Specialization: Clinical
LP 4508 MN Behavioral Health & Social Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
MN 148445100 05
MN BLUE CROSS BLUE SHEILD 572G1EN 01

Office Location

Street Address 889 GRAND AVE
SUITE 202
City SAINT PAUL
State MN
Zip Code 55105-3008

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Taxonomy Information

Taxonomy Code 103TC0700X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist
Specialization Clinical

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1669992186 Stephanie Bruss Psychologist 821 Raymond Ave # 130c, Saint Paul, MN 55114-1503 2017-06-26
1679977326 Jennifer D. Karel Psychologist 1123 Grand Ave Ste 301, Saint Paul, MN 55105-2629 2014-10-09
1699038265 Minnesota Organization On Fetal Alcohol Syndrome (mofas) Psychologist 2233 University Ave W Ste 395, Saint Paul, MN 55114-1600 2012-06-19
1821356098 Mainhia Khang Psychologist 393 Dunlap St N Ste 105, Saint Paul, MN 55104-4211 2012-04-25
1609153378 Quo Psychotherapy, P.a. Psychologist 821 Raymond Ave Ste 230c, Saint Paul, MN 55114-1525 2011-11-09
1831486216 Bonnie Sue Mcmillin Psychologist 457 Portland Ave, 3, Saint Paul, MN 55102-2499 2011-07-06
1285935064 Sarah L. Hart, Ph.d., LLC Psychologist 241 Cleveland Ave S Ste P, Saint Paul, MN 55105-1208 2010-11-09
1003149717 Tamarind Knutson Psychologist 1360 Energy Park Dr Ste 340, Saint Paul, MN 55108-5298 2009-09-13
1659604874 Andrea Elizabeth Anderson Psychologist 2383 University Ave W Ste 200, U.S. Bank Building, Second Floor, Saint Paul, MN 55114-1603 2009-09-08
1114062551 Beth Prouty Psychologist 1918 Lincoln Ave, Saint Paul, MN 55105-1421 2007-02-21
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City SAINT PAUL
Zip Code 55105

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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