Individual provider Active NPI

Heather Pleickhardt, PHD

  • Clinical Psychologist
  • Boynton Beach, FL
National Provider Identifier
1184084915
Registry record updated Aug 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY9693 Issued in FL
Practice address
112 Newlake Dr
Boynton Beach, FL 33426-5472
Phone
(516) 473-8009
NPI assigned
Mar 7, 2016
Last updated
Aug 26, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 021352 NY
Clinical Psychologist 103TC0700X PY9693 FL Primary

Addresses

Primary practice location

112 Newlake Dr
Boynton Beach, FL 33426-5472

Mailing address

112 Newlake Dr
Boynton Beach, FL 33426-5472
Phone (516) 473-8009

Other practice location 1

165 N Village Ave
Suite 200
Rockville Centre, NY 11570-3761
Phone (516) 255-4100

Other practice location 2

817 N Dixie Hwy
Pompano Beach, FL 33060-5621
Phone (954) 785-8285 ext. 1010

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PY9693FLMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Teladoc Health Medical Group, P.a. Current Accepting new patients
On Course Psychological Counseling P.C. PastSince Jul 31, 2022 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: heatherpleickhardt@tdh.allscriptsdirect.net

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1457308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629936000000",
    "number": "1184084915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 NEWLAKE DR",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334265472",
            "telephone_number": "516-473-8009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 NEWLAKE DR",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334265472",
            "telephone_number": "516-473-8009"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "165 N Village Ave",
            "address_2": "Suite 200",
            "address_purpose": "LOCATION",
            "city": "Rockville Centre",
            "state": "NY",
            "postal_code": "115703761",
            "country_code": "US",
            "telephone_number": "516-255-4100",
            "fax_number": "516-255-4101",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "817 N Dixie Hwy",
            "address_purpose": "LOCATION",
            "city": "Pompano Beach",
            "state": "FL",
            "postal_code": "330605621",
            "country_code": "US",
            "telephone_number": "954-785-8285 x1010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PLEICKHARDT",
        "first_name": "HEATHER",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-07",
        "last_updated": "2021-08-26",
        "certification_date": "2021-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "021352",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY9693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boynton Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.