Individual provider Active NPI

Tracy Heinz, PSY.D.

  • Clinical Psychologist
  • Loveland, CO
National Provider Identifier
1811225337
Registry record updated Jan 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
4772 Issued in CO
Practice address
614 Roosevelt Ave
Loveland, CO 80537-5461
Phone
(480) 636-9111
NPI assigned
Nov 20, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X UNKNOWN AZ
Clinical Psychologist 103TC0700X 4772 CO Primary

Addresses

Primary practice location

614 Roosevelt Ave
Loveland, CO 80537-5461

Mailing address

614 Roosevelt Ave
Loveland, CO 80537-5461
Phone (480) 636-9111

Other practice location 1

5410 S Lakeshore Dr
Suite 102
Tempe, AZ 85283-2171
Phone (480) 636-9111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20181206002188 CO Practitioner - Clinical Psychologist 2567760234 Reassigns benefits to 1 organization
Practice locations: Loveland, CO

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

614 Roosevelt Ave
Loveland, CO 80537-5461

832 W Eisenhower Blvd
B4 Tree of Life Healing
Loveland, CO 80537-3134
Phone (970) 715-1070

P O Box
Suite 7024
Loveland, CO 80537-7024

PO Box
Suite 7024
Loveland, CO 80537-0024

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4772COMDProfessional Counselor
UNKNOWNAZMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Liv in-Home Counseling & Care Management, LLC Clinical CurrentSince Nov 19, 2018 Accepting new patients

Locations

1301 Riverside Ave
Fort Collins, CO 80524
Phone (970) 482-3680

2500 Dell Range Blvd
Cheyenne, WY 82009
Phone (307) 630-4729

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": "1258675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610323200000",
    "number": "1811225337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "614 ROOSEVELT AVE",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805375461",
            "telephone_number": "480-636-9111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "614 ROOSEVELT AVE",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805375461",
            "telephone_number": "480-636-9111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5410 S Lakeshore Dr",
            "address_2": "Suite 102",
            "address_purpose": "LOCATION",
            "city": "Tempe",
            "state": "AZ",
            "postal_code": "852832171",
            "country_code": "US",
            "telephone_number": "480-636-9111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEINZ",
        "first_name": "TRACY",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-11-20",
        "last_updated": "2021-01-11",
        "certification_date": "2021-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AZ",
            "license": "UNKNOWN",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "4772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loveland, CO

Sources for this page

Verify at the official NPI Registry.