Active NPI
Heather Marshall, PHD
- Clinical Psychologist
- Tallahassee, FL
National Provider Identifier
1568080299
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 071.011009
- Practice address
- 2450 Tim Gamble PL Ste 240
Tallahassee, FL 32308-4384 - Phone
- (708) 789-9539
- NPI assigned
- Jul 9, 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Clinical Psychologist | 103TC0700X | 071.011009 | IL | Primary |
| Clinical Psychologist | 103TC0700X | PY12754 | FL |
Addresses
Primary practice location
2450 Tim Gamble PL Ste 240
Tallahassee, FL 32308-4384
Mailing address
2450 Tim Gamble PL Ste 240
Tallahassee, FL 32308-4384
Phone (708) 789-9539
Other practice location 1
770 Lake Cook Rd Ste 200
Deerfield, IL 60015-4920
Phone (847) 219-4249
Other practice location 2
4 Allegheny Ctr Fl 8
Pittsburgh, PA 15212-5255
Phone (412) 330-4391
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
| License | State | Type | Specialty |
|---|---|---|---|
| PY12754 | FL | MD | Clinical Psychologist |
| 071.011009 | IL | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wise Mind Psychology Services PLLC | Clinical | Current | Accepting new patients |
Locations
2450 Tim Gamble Pl
Ste 240
Tallahassee, FL 32308
Phone (708) 789-9539
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.
-
- Clinical Psychologist
- Tallahassee, FL
- NPI 1043148661
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1594252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1765238400000",
"number": "1568080299",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2450 TIM GAMBLE PL STE 240",
"city": "TALLAHASSEE",
"state": "FL",
"postal_code": "323084384",
"telephone_number": "708-789-9539"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2450 TIM GAMBLE PL STE 240",
"city": "TALLAHASSEE",
"state": "FL",
"postal_code": "323084384",
"telephone_number": "708-789-9539"
}
],
"practiceLocations": [
{
"address_1": "770 Lake Cook Rd Ste 200",
"address_purpose": "LOCATION",
"city": "Deerfield",
"state": "IL",
"postal_code": "600154920",
"country_code": "US",
"telephone_number": "847-219-4249",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4 Allegheny Ctr Fl 8",
"address_purpose": "LOCATION",
"city": "Pittsburgh",
"state": "PA",
"postal_code": "152125255",
"country_code": "US",
"telephone_number": "412-330-4391",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MARSHALL",
"first_name": "HEATHER",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-07-09",
"last_updated": "2025-12-09",
"certification_date": "2025-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IL",
"license": "071.011009",
"primary": true
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "FL",
"license": "PY12754",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tallahassee, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.