Heather L Beaudry, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

TN2735 Issued in TN

Practice address

1907 N Roan St Ste 207
Johnson City, TN 37601-3182

Phone

(423) 282-0164

NPI assigned

Nov 15, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Behavioral Healthcare Consultants, P.C.

  • Psychologist
  • Lancaster, PA
  • NPI 1407831027
  NPD (past)

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

{
    "created_epoch": "1132012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618185600000",
    "number": "1760464937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1907 N ROAN ST STE 207",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376013182",
            "telephone_number": "423-282-0164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1907 N ROAN ST STE 207",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376013182",
            "telephone_number": "423-282-0164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAUDRY",
        "first_name": "HEATHER",
        "middle_name": "L",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-15",
        "last_updated": "2021-04-12",
        "certification_date": "2021-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TN",
            "license": "TN2735",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "042017",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hlbeaudrybhc@comcast.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1907 N Roan St Ste 207",
            "city": "Johnson City",
            "state": "TN",
            "country_code": "US",
            "postal_code": "376013182",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• David A Beaird, MD
• Courtney Evelyn Bean, LPN
• Christy Rayne Beane, PHARM.D.
• Sheila Francine Beasley, CRNA
• Dayla Beaudrot, DPT
• Brooklyn Beaupre, AG-ACNP
• Walter R Beaver, M.D.
• Emily Kendall Beck, PH.D.
• Andrew L Becker, D.O.
• Teresa A. Becker, NP

• Clinical Psychologist in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Clinical Psychologist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.