Matthew Heermann, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

3632 Issued in CO

Practice address

2249 Willard Loop Dr 104 Ucb
Boulder, CO 80309-5311

Phone

(303) 492-2277

NPI assigned

Sep 15, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1284508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652227200000",
    "number": "1891003513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2251 GLENARM PL",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802053124",
            "telephone_number": "720-235-8255",
            "fax_number": "720-235-8255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2249 WILLARD LOOP DR 104 UCB",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803095311",
            "telephone_number": "303-492-2277"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2251 Glenarm Pl",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802053124",
            "country_code": "US",
            "telephone_number": "720-235-8255",
            "fax_number": "720-235-8255",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEERMANN",
        "first_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-09-15",
        "last_updated": "2022-05-11",
        "certification_date": "2022-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "3632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Boulder, CO
• Providers in Boulder, CO by specialty
• Clinical Psychologist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2022; 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.