Heather Dermyer, LLC

Primary specialty

PsychologistTaxonomy code 103T00000X

License

6301014186 Issued in MI

Legal business name

HEATHER DERMYER, LLC

Practice address

3330 Centennial RDG
#205
Grand Rapids, MI 49546-7098

Phone

(906) 250-3191

NPI assigned

May 20, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Heather Lynn Dermyer, PH.D.NPI 1114230786

Title

Psychologist

Phone

(906) 250-3191

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Heather L Dermyer, PH.D.

  • Clinical Psychologist
  • Traverse City, MI
  • NPI 1114230786
  NPD (past) Authorized official

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

{
    "created_epoch": "1463702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463702400000",
    "number": "1851748768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3330 CENTENNIAL RDG",
            "address_2": "#205",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495467098",
            "telephone_number": "906-250-3191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3330 CENTENNIAL RDG",
            "address_2": "#205",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495467098",
            "telephone_number": "906-250-3191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEATHER DERMYER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-20",
        "last_updated": "2016-05-20",
        "status": "A",
        "authorized_official_last_name": "DERMYER",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "906-250-3191",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301014186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 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.