Active NPI
Jerry W Heiderich, LMFT
- Marriage & Family Therapist
- Denton, TX
National Provider Identifier
1932501244
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 4760
- Practice address
- 723 S I 35 E Ste 110
Denton Square Business Center
Denton, TX 76205-4102 - Phone
- (940) 483-1789
- NPI assigned
- Sep 17, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 4760 | TX | Primary |
Addresses
Primary practice location
723 S I 35 E Ste 110
Denton Square Business Center
Denton, TX 76205-4102
Mailing address
505 Fairway Meadows Dr
Garland, TX 75044-5069
Phone (214) 862-8964
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 27, 2024 through Jan 27, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4760 | TX | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1410912000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1410912000000",
"number": "1932501244",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "505 FAIRWAY MEADOWS DR",
"city": "GARLAND",
"state": "TX",
"postal_code": "750445069",
"telephone_number": "214-862-8964"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "723 S I 35 E STE 110",
"address_2": "DENTON SQUARE BUSINESS CENTER",
"city": "DENTON",
"state": "TX",
"postal_code": "762054102",
"telephone_number": "940-483-1789"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEIDERICH",
"first_name": "JERRY",
"middle_name": "W",
"credential": "LMFT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-09-17",
"last_updated": "2014-09-17",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "TX",
"license": "4760",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Denton, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.