Individual provider Active NPI

Heidi Elaine Wyman, PHD

  • Marriage & Family Therapist
  • Tempe, AZ
National Provider Identifier
1497801781
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFT10036 Issued in AZ
Practice address
1232 E Broadway Rd
Ste 120
Tempe, AZ 85282-1511
Phone
(480) 784-1514
Fax
(480) 963-3294
NPI assigned
Jan 27, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFT10036 AZ Primary

Addresses

Primary practice location

1232 E Broadway Rd
Ste 120
Tempe, AZ 85282-1511

Mailing address

2671 E Milky Way
Gilbert, AZ 85296-9131
Phone (480) 279-6292

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
MFT10036AZMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Empact Past Accepting new patients

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": "1169856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497801781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2671 E MILKY WAY",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852969131",
            "telephone_number": "480-279-6292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1232 E BROADWAY RD",
            "address_2": "STE 120",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852821511",
            "telephone_number": "480-784-1514",
            "fax_number": "480-963-3294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYMAN",
        "first_name": "HEIDI",
        "middle_name": "ELAINE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "AZ",
            "license": "MFT10036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tempe, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.