Individual provider Active NPI

Heather Anne Cerridwen, LLP

  • Psychologist
  • Kalamazoo, MI
National Provider Identifier
1811012040
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
6301012941 Issued in MI
Practice address
2615 Stadium Drive
Kalamazoo, MI 49008-1654
Phone
(269) 343-1651
Fax
(269) 382-7078
NPI assigned
Mar 20, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 6301012941 MI Primary

Addresses

Primary practice location

2615 Stadium Drive
Kalamazoo, MI 49008-1654

Mailing address

2615 Stadium Drive
Kalamazoo, MI 49008-1654
Phone (269) 343-1651

Other names 1

  • Heather Bednarz Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20260507001769 MI Practitioner - Mental Health Counselor 1850869892 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Western Michigan Un Homer Stryker School of Med, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rinehart Institute PLLCGroup PAC ID 1254808777, 6 clinicians

Practice addresses (Care Compare)

5400 Holiday Ter
Suite DB
Kalamazoo, MI 49009-2110
Phone (269) 381-8191

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6301012941MIMDPsychologist

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": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811012040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2615 STADIUM DRIVE",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490081654",
            "telephone_number": "269-343-1651",
            "fax_number": "269-382-7078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2615 STADIUM DRIVE",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490081654",
            "telephone_number": "269-343-1651",
            "fax_number": "269-382-7078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CERRIDWEN",
        "first_name": "HEATHER",
        "middle_name": "ANNE",
        "credential": "LLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301012941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEATHER",
            "last_name": "BEDNARZ",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.