Individual provider Active NPI

Heather A Byrne, PHD

  • Psychologist
  • Mequon, WI
National Provider Identifier
1942219589
Registry record updated Feb 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
1943-057 Issued in WI
Practice address
14135 N Cedarburg Rd
# 203
Mequon, WI 53097-1416
Phone
(414) 588-8822
NPI assigned
Aug 5, 2006
Last updated
Feb 13, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 1943-057 WI Primary
Psychologist 103T00000X 35573-057 MS

Addresses

Primary practice location

14135 N Cedarburg Rd
# 203
Mequon, WI 53097-1416

Mailing address

14135 N Cedarburg Rd
# 203
Mequon, WI 53097-1416
Phone (414) 588-8822

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20050721000394 WI Practitioner - Clinical Psychologist 3870520885 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

14135 N Cedarburg Rd
Suite 203
Mequon, WI 53097-1416
Phone (414) 588-8822

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
35573-057MSMDPsychologist
1943-057WIMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Heather a Byrne PHD Psychological Services LLC Psychologist CurrentSince May 24, 2017 Accepting new patients
Melainie Tuggle MSW, LLC PastSince Sep 10, 2023 Accepting new patients
Wisconsin Community Mental Health Counseling Centers, Inc Past Accepting new patients

Locations

14135 N Cedarburg Rd
#203
Mequon, WI 53097
Phone (414) 588-8822

14135 N Cedarburg Rd
Ste 203
Mequon, WI 53097
Phone (262) 377-2006

4465 N Oakland Ave
Shorewood, WI 53211
Phone (414) 354-3620

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1486944000000",
    "number": "1942219589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14135 N CEDARBURG RD",
            "address_2": "# 203",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530971416",
            "telephone_number": "414-588-8822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14135 N CEDARBURG RD",
            "address_2": "# 203",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530971416",
            "telephone_number": "414-588-8822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BYRNE",
        "first_name": "HEATHER",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-05",
        "last_updated": "2017-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "1943-057",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MS",
            "license": "35573-057",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mequon, WI

Sources for this page

Verify at the official NPI Registry.