Individual provider Active NPI

Alexandra Hiatt Duffy, PSY.D.

  • Clinical Psychologist
  • Charlotte, NC
National Provider Identifier
1891856571
Registry record updated Jul 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY20193 Issued in CA
Practice address
11220 Elm LN Ste 203
Charlotte, NC 28277-0450
Phone
(704) 654-1920
NPI assigned
Dec 13, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY.0006764 CO
Clinical Psychologist 103TC0700X PSY5000163 MA
Clinical Psychologist 103TC0700X 3202 NC
Clinical Psychologist 103TC0700X PSY20193 CA Primary

Addresses

Primary practice location

11220 Elm LN Ste 203
Charlotte, NC 28277-0450

Mailing address

11220 Elm LN Ste 203
Charlotte, NC 28277-0450
Phone (704) 654-1970

Other practice location 1

439 Edwards Access Rd
Edwards, CO 81632-5634
Phone (970) 445-2489

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
I20250909001083 CO Practitioner - Clinical Psychologist 5496257370 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Eagle Valley Mental HealthGroup PAC ID 6204297450, 32 clinicians

Practice addresses (Care Compare)

439 Edwards Access Rd
VHBH Wiegers Mental Health Clinic
Edwards, CO 81632-5634
Phone (970) 445-2489

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY20193CAMDClinical Psychologist
PSY5000163MAMDClinical Psychologist
3202NCMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Eagle Valley Mental Health CurrentSince Sep 8, 2025 Accepting new patients
Eagle Valley Mental Health Current Accepting new patients
Eagle Valley Mental Health CurrentSince Sep 8, 2025 Accepting new patients

Locations

439 Edwards Access Rd
Edwards, CO 81632
Phone (970) 455-2489

Organizations & group practices 3

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": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753920000000",
    "number": "1891856571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11220 ELM LN STE 203",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282770450",
            "telephone_number": "704-654-1970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11220 ELM LN STE 203",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282770450",
            "telephone_number": "704-654-1920"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "439 Edwards Access Rd",
            "address_purpose": "LOCATION",
            "city": "Edwards",
            "state": "CO",
            "postal_code": "816325634",
            "country_code": "US",
            "telephone_number": "970-445-2489",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUFFY",
        "first_name": "ALEXANDRA",
        "middle_name": "HIATT",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-13",
        "last_updated": "2025-07-31",
        "certification_date": "2025-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "PSY.0006764",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "PSY5000163",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "3202",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY20193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.