Active NPI
Heather Lynne McDonald, PSY.D.
- Clinical Psychologist
- Wilkes Barre, PA
National Provider Identifier
1437789112
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PS018969
- Practice address
- 1111 E End Blvd
Wilkes Barre, PA 18711-0030 - Phone
- (570) 824-3521
- NPI assigned
- Jan 22, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PS018969 | PA | Primary |
Addresses
Primary practice location
1111 E End Blvd
Wilkes Barre, PA 18711-0030
Mailing address
413 Bodle Rd
Wyoming, PA 18644-6014
Phone (570) 417-9229
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS018969 | PA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1579651200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1579651200000",
"number": "1437789112",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "413 BODLE RD",
"city": "WYOMING",
"state": "PA",
"postal_code": "186446014",
"telephone_number": "570-417-9229"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1111 E END BLVD",
"city": "WILKES BARRE",
"state": "PA",
"postal_code": "187110030",
"telephone_number": "570-824-3521"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCDONALD",
"first_name": "HEATHER",
"middle_name": "LYNNE",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-01-22",
"last_updated": "2020-01-22",
"certification_date": "2020-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "PA",
"license": "PS018969",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wilkes Barre, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.