Individual provider Active NPI

Tracy Stevens Hejmanowski, PH.D

  • Clinical Psychologist
  • Norfolk, VA
National Provider Identifier
1609964923
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
0810003600 Issued in VA
Practice address
249 W York St
Norfolk, VA 23510-1520
Phone
(757) 622-6794
Fax
(757) 626-1509
NPI assigned
Oct 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY10703 FL
Clinical Psychologist 103TC0700X 0810003600 VA Primary

Addresses

Primary practice location

249 W York St
Norfolk, VA 23510-1520

Mailing address

249 W York St
Norfolk, VA 23510-1520
Phone (757) 622-6794

Other identifiers 1

IdentifierTypeStateIssuer
010316499MedicaidVA

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
0810003600VAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Community Psychological Resources 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": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1609964923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "249 W YORK ST",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235101520",
            "telephone_number": "757-622-6794",
            "fax_number": "757-626-1509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "249 W YORK ST",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235101520",
            "telephone_number": "757-622-6794",
            "fax_number": "757-626-1509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEJMANOWSKI",
        "first_name": "TRACY",
        "middle_name": "STEVENS",
        "credential": "PH.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-11",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY10703",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810003600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010316499",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2024; 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.