Individual provider Active NPI

Heather Smith, PSY.D

  • Psychologist
  • Cincinnati, OH
National Provider Identifier
1205355757
Registry record updated Jul 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
P.07999 Issued in OH
Practice address
126 Wellington PL
Cincinnati, OH 45219-1710
Phone
(513) 268-8306
NPI assigned
Sep 15, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X P.07999 OH Primary

Addresses

Primary practice location

126 Wellington PL
Cincinnati, OH 45219-1710

Mailing address

126 Wellington PL
Cincinnati, OH 45219-1710
Phone (513) 268-8306

Other practice location 1

4968 Glenway Ave
Cincinnati, OH 45238-3902
Phone (513) 853-6575 ext. 1567

Other practice location 2

2600 Victory Pkwy
Cincinnati, OH 45206-1395
Phone (513) 751-7747

Other identifiers 1

IdentifierTypeStateIssuer
0290690MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20200317001049 OH Practitioner - Clinical Psychologist 9032547567 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Talbert House CurrentSince Jan 16, 2020 Accepting new patients

Locations

2600 Victory Pkwy
Cincinnati, OH 45206
Phone (513) 872-5863

1515 Carll St
Cincinnati, OH 45225
Phone (513) 244-3985

4968 Glenway Ave
Cincinnati, OH 45238
Phone (513) 471-6000

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1505433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751500800000",
    "number": "1205355757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 WELLINGTON PL",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452191710",
            "telephone_number": "513-268-8306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 WELLINGTON PL",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452191710",
            "telephone_number": "513-268-8306"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4968 Glenway Ave",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452383902",
            "country_code": "US",
            "telephone_number": "513-853-6575 x1567",
            "fax_number": "513-853-6587",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2600 Victory Pkwy",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452061395",
            "country_code": "US",
            "telephone_number": "513-751-7747",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "HEATHER",
        "credential": "PSY.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-15",
        "last_updated": "2025-07-03",
        "certification_date": "2025-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OH",
            "license": "P.07999",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0290690",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.