Heather T Whittall, PSYD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

3829 Issued in CO

Practice address

1800 30TH St Ste 212
Boulder, CO 80301-1087

Phone

(720) 591-4664

NPI assigned

Aug 27, 2010

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Apr 1, 2025 through Apr 1, 2027

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Boulder Valley Psychotherapy Inc.

  • Psychologist
  • Boulder, CO
  • NPI 1407347487
  NPD Authorized official

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

{
    "created_epoch": "1282867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735171200000",
    "number": "1154637189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 30TH ST STE 212",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803011087",
            "telephone_number": "720-591-4664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 30TH ST STE 212",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803011087",
            "telephone_number": "720-591-4664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITTALL",
        "first_name": "HEATHER",
        "middle_name": "T",
        "name_prefix": "Ms.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-27",
        "last_updated": "2024-12-26",
        "certification_date": "2024-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "CO",
            "license": "3829",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CO",
            "license": "3829",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "79600573",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER COMMERCIAL NUMBER",
            "identifier": "022463",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David Michael Whitling
• Rachelpenina Whitmore-Bard
• Whitney Swander Audiology Inc
• Brandy Sue Whitney, MSPT
• Meagan Whitney, LPC
• Ashley Whittemore, RD
• Janet F Whittet
• Athena Whittington
• Judette A Whitworth, RN
• Whole Body Balance, Inc.

• Psychologist in Boulder, CO
• Providers in Boulder, CO by specialty
• Psychologist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.