Heidi Marie Maxwell

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0810006146 Issued in VA

Practice address

135 E 38TH St
Erie, PA 16504-1559

Phone

(814) 488-3732

NPI assigned

Apr 30, 2014

Last updated

Aug 19, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Miss Heidi Marie Pederson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1398816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660867200000",
    "number": "1598175440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 E 38TH ST BLDG 8",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165041559",
            "telephone_number": "814-488-3732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 E 38TH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165041559",
            "telephone_number": "814-488-3732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAXWELL",
        "first_name": "HEIDI",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-30",
        "last_updated": "2022-08-19",
        "certification_date": "2022-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810006146",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEIDI",
            "last_name": "PEDERSON",
            "middle_name": "MARIE",
            "prefix": "MISS",
            "credential": "PSYD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kathleen Mary Mattocks, RN
• Michael John Mauro, PT
• Rachel Shopene Mauro, DPT
• Maxim Healthcare Services, Inc.
• Maximal Gain Chiropractic Center, PLLC
• Alan J May, LCSW
• Jennette Marie May, RN
• Linda S May, D.O.
• Lisa Marie May, PHD
• Preston Davis May, D.O.

• Clinical Psychologist in Erie, PA
• Providers in Erie, PA by specialty
• Clinical Psychologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2022; 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.