Mark E Heim, CLINICAL PSYCH

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6301019013 Issued in MI

Practice address

6548 Town Center Dr
Clarkston, MI 48346-4823

Phone

(248) 460-9731

NPI assigned

Feb 3, 2006

Last updated

Nov 17, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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 MI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Richard Kneip, PH.D., P.C.

  dba Great Lakes Psychology Group

  • Community/Behavioral Health Agency
  • Clarkston, MI
  • NPI 1679739700
  Medicare reassignment NPD

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

{
    "created_epoch": "1138924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637107200000",
    "number": "1285606103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4041 ARDSLEY CT",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483485059",
            "telephone_number": "757-589-1233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6548 TOWN CENTER DR",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483464823",
            "telephone_number": "248-460-9731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEIM",
        "first_name": "MARK",
        "middle_name": "E",
        "credential": "CLINICAL PSYCH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-03",
        "last_updated": "2021-11-17",
        "certification_date": "2021-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "2664",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301019013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Healthquest Physical Therapy and Wellness Center of Clarkston LLC (HealthQuest Physical Therapy and Wellness)
• Pam Heany
• Kaeleigh Heatley, LLMSW
• Alexis Ann Hegedus, LLMSW
• Stephanie Denise Wilson Hegle, LPC
• Mary Ann Hennig, LMSW, ACSW, BCD
• Henry Ford Hospital
• Madison Henry, LMSW
• Milly Yvonne Henry
• Ava Herberger

• Clinical Psychologist in Clarkston, MI
• Providers in Clarkston, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.