Individual provider Active NPI

Thomas L. Heiskell, PH.D.

  • Clinical Psychologist
  • Portsmouth, OH
National Provider Identifier
1871502104
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3163 Issued in OH
Practice address
806 6TH St
Suite 312
Portsmouth, OH 45662-4158
Phone
(740) 353-5033
Fax
(740) 353-5033
NPI assigned
Aug 5, 2006
Sex
Male
Sole proprietor
Yes

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
Clinical Psychologist 103TC0700X 3163 OH Primary

Addresses

Primary practice location

806 6TH St
Suite 312
Portsmouth, OH 45662-4158

Mailing address

1132 29TH St
Portsmouth, OH 45662-2231
Phone (740) 353-3464

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
3163OHMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871502104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1132 29TH ST",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456622231",
            "telephone_number": "740-353-3464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "806 6TH ST",
            "address_2": "SUITE 312",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456624158",
            "telephone_number": "740-353-5033",
            "fax_number": "740-353-5033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEISKELL",
        "first_name": "THOMAS",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "3163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portsmouth, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.