Heidi Rachelle Tennyson, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY60217255 Issued in WA

Practice address

1505 Shakespeare Dr
Centralia, WA 98531-8501

Phone

(360) 360-5044

Fax

(360) 360-2362

NPI assigned

Sep 3, 2007

Last updated

Sep 4, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA, ID2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Clinical Psychologist

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Dynamic Balance Psychology PLLC

  • Clinical Psychologist
  • Centralia, WA
  • NPI 1265261010
  Medicare reassignment NPD Authorized official
• Cornerstone Psychological Associates, PLLC

  • Clinical Psychologist
  • Boise, ID
  • NPI 1184766396
  Medicare reassignment NPD

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

{
    "created_epoch": "1188777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756944000000",
    "number": "1043404064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1121 HARRISON AVE # 269",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "985311852",
            "telephone_number": "360-360-5044",
            "fax_number": "360-360-2362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 SHAKESPEARE DR",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "985318501",
            "telephone_number": "360-360-5044",
            "fax_number": "360-360-2362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TENNYSON",
        "first_name": "HEIDI",
        "middle_name": "RACHELLE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-03",
        "last_updated": "2025-09-04",
        "certification_date": "2025-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY60217255",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "ID",
            "license": "PSY203058",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachael Evonne Taylor, CPSS
• Tessia Renee Taylor, MS, LMHCA
• Team Health, Inc
• Craig M Tedder, DPT
• Darice Teitzel
• Stephanie F Terry, BSW, AAC
• James Wilford Tetz, D.D.S.
• Atul Thakker, M.D.
• Duong Thuy Than, M.D.
• Jessica Thayer, BA, AAC

• Clinical Psychologist in Centralia, WA
• Providers in Centralia, WA by specialty
• Clinical Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.