Individual provider Active NPI

Heather Deanne Wyatt

  • Clinical Psychologist
  • New Brighton, MN
National Provider Identifier
1801745377
Registry record updated Jan 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
LP7313 Issued in MN
Practice address
900 Long Lake Rd Ste 160
New Brighton, MN 55112-6414
Phone
(612) 706-9630
NPI assigned
Jan 27, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X LP7313 MN Primary

Addresses

Primary practice location

900 Long Lake Rd Ste 160
New Brighton, MN 55112-6414

Mailing address

8020 N Savanna Rd
Floodwood, MN 55736-8221

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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

Enrollment IDStateProvider typePAC IDDetails
I20260225001654 MN Practitioner - Clinical Psychologist 0941781256 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

900 Long Lake Rd
Suite 160
New Brighton, MN 55112-6414

900 Long Lake Rd
Suite 160
New Brighton, MN 55112-6440

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LP7313MNMDClinical Psychologist
7313MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Care Services, PA CurrentSince Feb 15, 2026 Accepting new patients
Health and Wellness Collaborative Clinical CurrentSince Feb 15, 2026 Accepting new patients

Locations

900 Long Lake Rd
Ste 160
Saint Paul, MN 55112
Phone (612) 706-9630

Organizations & group practices 2

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": "1769472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769472000000",
    "number": "1801745377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8020 N SAVANNA RD",
            "city": "FLOODWOOD",
            "state": "MN",
            "postal_code": "557368221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 LONG LAKE RD STE 160",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551126414",
            "telephone_number": "612-706-9630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYATT",
        "first_name": "HEATHER",
        "middle_name": "DEANNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-01-27",
        "last_updated": "2026-01-27",
        "certification_date": "2026-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP7313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Brighton, MN

Sources for this page

Verify at the official NPI Registry.