Andrew Roth-Heinlein, PSYD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PY61060434 Issued in WA

Practice address

1616 Cornwall Ave Ste 205
Bellingham, WA 98225-4642

Phone

(360) 676-6177

Fax

(360) 671-3574

NPI assigned

Feb 27, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

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

Specialty

Clinical Psychologist

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Unity Care NorthwestGroup PAC ID 7911897699, 39 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Unity Care Northwest

  • Federally Qualified Health Center (FQHC)
  • Bellingham, WA
  • NPI 1760430532
  Medicare reassignment Care Compare group NPD
• Unity Care Northwest

  • Federally Qualified Health Center (FQHC)
  • Bellingham, WA
  • NPI 1316785207
  NPD

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

{
    "created_epoch": "1361923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663804800000",
    "number": "1952641086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1616 CORNWALL AVE STE 205",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982254642",
            "telephone_number": "360-676-6177",
            "fax_number": "360-671-3574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1616 CORNWALL AVE STE 205",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982254642",
            "telephone_number": "360-676-6177",
            "fax_number": "360-671-3574"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "859 Willard St",
            "address_purpose": "LOCATION",
            "city": "Quincy",
            "state": "MA",
            "postal_code": "021697482",
            "country_code": "US",
            "telephone_number": "617-847-1950",
            "fax_number": "617-774-1490",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROTH-HEINLEIN",
        "first_name": "ANDREW",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-02-27",
        "last_updated": "2022-09-22",
        "certification_date": "2022-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WA",
            "license": "PY61060434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Katrina Ross, MD
• Jamie Marie Ross, MS
• Jessica Ann Ross, PA-C, ATC
• Kristina Ross, MD
• Tonya Ross, LMT
• Lori Lynn Roth
• Page Roth, LMHC
• Kimberly Rothwell
• Adriana Carolina Rouquayrol, LMP
• Andrea Rowe, PTA

• Psychologist in Bellingham, WA
• Providers in Bellingham, WA by specialty
• Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.