Nicole Heffron, LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

LP 4508 Issued in MN

Legal business name

NICOLE HEFFRON, LLC

Practice address

889 Grand Ave
Suite 202
Saint Paul, MN 55105-3008

Phone

(651) 224-1541

Fax

(651) 224-3501

NPI assigned

Jun 29, 2009

Organization subpart

No

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

Authorized official

Name

Ms. Nicole Englund Heffron, PH.D.NPI 1831102839

Title

Licensed Psychologist

Phone

(651) 224-1541

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nicole Englund Heffron, NICOLE HEFFRON

  • Clinical Psychologist
  • Minneapolis, MN
  • NPI 1831102839
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1246233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1246233600000",
    "number": "1639307622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "889 GRAND AVE",
            "address_2": "SUITE 202",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551053008",
            "telephone_number": "651-224-1541",
            "fax_number": "651-224-3501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "889 GRAND AVE",
            "address_2": "SUITE 202",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551053008",
            "telephone_number": "651-224-1541",
            "fax_number": "651-224-3501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NICOLE HEFFRON, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-29",
        "last_updated": "2009-06-29",
        "status": "A",
        "authorized_official_last_name": "HEFFRON",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "ENGLUND",
        "authorized_official_title_or_position": "LICENSED PSYCHOLOGIST",
        "authorized_official_telephone_number": "651-224-1541",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP 4508",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD",
            "identifier": "572G1EN",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "148445100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Diane Nickeson-Mendheim
• Lisa Babcock Nicklay, RPH
• Maiya Nicklay
• James D Nickman, DDS
• Sarah Margaret Nicolai, M.D.
• Cynthia E Niederjohn, M.A., CCC SLP
• Ann Elizabeth Niedermayer
• Aline Marie Niehues, CNP
• Casey Claire Rose Nielsen
• Jenna Nielsen

• Clinical Psychologist in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Clinical Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.