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DR. ELIZABETH ANNE HEIDENREICH PSY.D. LP
NPI 1124370358
Psychologist - Clinical in Edina, MN

Active since October 11, 2012Opted out of Medicare · through May 20, 2028
5200 WILLSON ROAD, SUITE 150, EDINA, MN 55424(612) 208-8087(651) 628-0411 Get Directions Write a Review

NPPES record last updated: May 6, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 6, 2024, Apr 30, 2018 (2 updates tracked since 2018).

About Dr. Elizabeth Anne Heidenreich Psy.d. Lp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. ELIZABETH ANNE HEIDENREICH PSY.D. LP (NPI 1124370358) is an individual clinical provider in Edina, Minnesota, licensed in Minnesota (GL0077) and active in the NPI registry since October 2012. She has opted out of Medicare through May 20, 2028.

NPPES Registry Identity

NPI1124370358
Entity TypeIndividualFemale
Primary Taxonomy103TC0700X
Provider Legal NameDR. ELIZABETH ANNE HEIDENREICHCredential: PSY.D. LP
Location Address5200 WILLSON ROAD, SUITE 150Edina, MN 55424
Mailing Address5200 Willson Road, Suite 150Edina, MN 55424 · (612) 208-8087 · Fax (651) 628-0411
Phone(612) 208-8087
Fax(651) 628-0411
Sole ProprietorYes
Enumeration DateOctober 11, 2012
Last NPPES UpdateMay 6, 20242 updates tracked since enumeration
✔ NPI 1124370358 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
Licenses✔ Licensed in MN · GL0077✔ Licensed in DC · PSY1000836✔ Licensed in MD · 05232
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
5200 WILLSON ROAD, Edina, MN 55424
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Elizabeth Anne Heidenreich Psy.d. Lp has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from May 20, 2024 through May 20, 2028.

Opt-Out Effective DateMay 20, 2024
Opt-Out In Effect ThroughMay 20, 2028Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KAREN ALLBRIGHT JONES LMFT
Marriage & Family Therapist
5200 WILLSON ROAD, SUITE 205
EDINA, MN 55424
Hennepin County (952) 920-2459

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Elizabeth Heidenreich's NPI number?

The NPI number for Elizabeth Heidenreich is 1124370358. It was assigned to this individual provider in the NPPES registry on October 11, 2012.

Where is Elizabeth Heidenreich located?

Elizabeth Heidenreich practices at 5200 Willson Road Suite 150, Edina, MN 55424. The listed phone number is (612) 208-8087.

What is Elizabeth Heidenreich's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Elizabeth Heidenreich enrolled in Medicare?

No. Elizabeth Heidenreich has opted out of Medicare through May 20, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Elizabeth Heidenreich was last updated on May 6, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.