Heidi Mathie Mucha, PH.D

Primary specialty

PsychologistTaxonomy code 103T00000X

License

9136519-2501 Issued in UT

Practice address

2697 S Kenwood St
Salt Lake City, UT 84106-3627

Phone

(801) 631-9632

NPI assigned

Jul 7, 2016

Last updated

Jul 7, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1467849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467849600000",
    "number": "1649622234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2697 S KENWOOD ST",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841063627",
            "telephone_number": "801-631-9632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2697 S KENWOOD ST",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841063627",
            "telephone_number": "801-631-9632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUCHA",
        "first_name": "HEIDI",
        "middle_name": "MATHIE",
        "name_prefix": "Dr.",
        "credential": "PH.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-07",
        "last_updated": "2016-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "UT",
            "license": "9136519-2501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Psychologist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2016; 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.