Active NPI
Heather Jean Dawson, PH.D.
- Psychologist
- Shirley, NY
National Provider Identifier
1952490955
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 013054
- Practice address
- 123 Johns Neck Rd
Shirley, NY 11967-4100 - Phone
- (212) 886-3773
- NPI assigned
- Oct 11, 2006
- Last updated
- Aug 27, 2026
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | NU | ||
| Psychologist | 103T00000X | 013054 | NY | Primary |
Addresses
Primary practice location
123 Johns Neck Rd
Shirley, NY 11967-4100
Mailing address
123 Johns Neck Rd
Shirley, NY 11967-4100
Phone (212) 886-3773
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0245862C | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Opted out of Medicare
- Yes, effective Jun 1, 2026 through Jun 1, 2028
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040329000022 | NY | Practitioner - Clinical Psychologist | 3173415759 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 013054 | NY | MD | Medical Physician Assistant |
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787788800000",
"number": "1952490955",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "123 JOHNS NECK RD",
"city": "SHIRLEY",
"state": "NY",
"postal_code": "119674100",
"telephone_number": "212-886-3773"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "123 JOHNS NECK RD",
"city": "SHIRLEY",
"state": "NY",
"postal_code": "119674100",
"telephone_number": "212-886-3773"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAWSON",
"first_name": "HEATHER",
"middle_name": "JEAN",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-11",
"last_updated": "2026-08-27",
"certification_date": "2026-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "013054",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0245862C",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Shirley, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2026; 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.