Heidi Ann Halla-Bauer, PSY.D

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY003092 Issued in GA

Practice address

300 Medical Dr
Ste 705
Lagrange, GA 30240-4130

Phone

(706) 885-0111

Fax

(706) 885-0607

NPI assigned

Jul 18, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

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 1

Specialty

Clinical Psychologist

Education

Other, 2006

Medicare assignment

May accept Medicare assignment

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 and National Provider Directory roles.

• Healthy Balance Psychology, LLC

  • Psychologist
  • Faribault, MN
  • NPI 1891312732
  Medicare reassignment NPD Authorized official
• Fernbrook Family Center, Inc

  • Social Worker
  • Owatonna, MN
  • NPI 1659483915
  Medicare reassignment NPD
• Fernbrook Family Center

  • Social Worker
  • Red Wing, MN
  • NPI 1437427911
  NPD (past)
• Fernbrook Family Center, Inc

  • Case Management Agency
  • Faribault, MN
  • NPI 1083537781
  NPD (past)
• Mears Psychological LLC

  dba The Soul's Apothecary

  • Clinical Psychologist
  • Lakeville, MN
  • NPI 1881333946
  NPD (past)
• River City Therapy Center, LLC

  dba River City Therapy Center

  • Community/Behavioral Health Agency
  • Red Wing, MN
  • NPI 1275279655
  NPD (past)

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

{
    "created_epoch": "1184716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232668800000",
    "number": "1154521292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 MEDICAL DR",
            "address_2": "STE 705",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302404130",
            "telephone_number": "706-885-0111",
            "fax_number": "706-885-0607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 MEDICAL DR",
            "address_2": "STE 705",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302404130",
            "telephone_number": "706-885-0111",
            "fax_number": "706-885-0607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALLA-BAUER",
        "first_name": "HEIDI",
        "middle_name": "ANN",
        "credential": "PSY.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-18",
        "last_updated": "2009-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "GA",
            "license": "PSY003092",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "874147128A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lawrence N Gynther, M.D.
• Gaye Hagan, LPC
• Brittainy Hall
• Kristen Baker Hall, CCC-SLP
• Halla-Bauer Psychological Services Corporation
• Marco Hallerbach, M.D.
• Taylor Hamm, MA
• Kristen Nicole Hammond, PA
• Kirk Hampton
• Hanger Prosthetics & Orthotics Inc (Hanger Clinic)

• Psychologist in Lagrange, GA
• Providers in Lagrange, GA by specialty
• Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2009; 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.