HEIDI JO HATHAWAY PSYD, LP
NPI 1780755256
Psychologist - Clinical in Brooklyn Center, MN

Active since November 13, 2006PECOS EnrolledAccepts Medicare Assignment
6200 SHINGLE CREEK PKWY STE 350, BROOKLYN CENTER, MN 55430(763) 503-8560(763) 503-8563 Get Directions Write a Review

NPPES record last updated: February 2, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Feb 2, 2023, Feb 27, 2017 (2 updates tracked since 2017).

About Heidi Jo Hathaway Psyd, Lp NPPES

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

HEIDI JO HATHAWAY PSYD, LP (NPI 1780755256) is an individual clinical provider in Brooklyn Center, Minnesota, licensed in Minnesota (LP3930) and active in the NPI registry since November 2006. She is enrolled in Medicare PECOS, maintains a secondary practice location in Minneapolis, and is a graduate of Other (1996).

NPPES Registry Identity

NPI1780755256
Entity TypeIndividualFemale
Primary Taxonomy103TC0700X
Provider Legal NameHEIDI JO HATHAWAYCredential: PSYD, LP
Location Address6200 SHINGLE CREEK PKWY STE 350Brooklyn Center, MN 55430-2155
Mailing Address4240 Park Glen RdSt Louis Park, MN 55416-5427 · (612) 925-6033 · Fax (612) 925-8496
Fax(763) 503-8563
Sole ProprietorNo
Medical School CMSOtherGraduated 1996
Enumeration DateNovember 13, 2006
Last NPPES UpdateFebruary 2, 20232 updates tracked since enumeration
NPPES CertifiedFebruary 2, 2023
NPI 1780755256 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License Licensed in MN · LP3930
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.

6200 SHINGLE CREEK PKWY STE 350, Brooklyn Center, MN 55430

Other Names 1

Former Name (1)Heidi Jo Reuteler-barnes

Secondary Practice Location 1

Location 14027 County Road 25Minneapolis, MN 55416-2629 · Phone (612) 925-6033 · Fax (612) 925-8496

Other Identifiers 4

Other123494MN · Ucare
Other61-34863MN · Medica
Medicaid050385100FM
Other11R21REMN · Bluecrossblueshield

Accepted Insurance

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Heidi Jo Hathaway Psyd, Lp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6204902240
PECOS Enrollment IDI20080827000592
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55430 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$168.28 typical visit price
range $56.00 – $168.28
Typical copayment $42.07 (range $14.00 – $42.07)
Most-billed visit code 99205
Established Patient
$98.61 typical visit price
range $18.32 – $138.04
Typical copayment $24.65 (range $4.58 – $34.51)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 4

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

Social Worker (Clinical)
6200 SHINGLE CREEK PKWY STE 350
BROOKLYN CENTER, MN 55430
Social Worker (Clinical)
6200 SHINGLE CREEK PKWY STE 350
BROOKLYN CENTER, MN 55430
Nurse Practitioner (Psychiatric/Mental Health)
6200 SHINGLE CREEK PKWY STE 350
BROOKLYN CENTER, MN 55430
Counselor (Professional)
6200 SHINGLE CREEK PKWY STE 350
BROOKLYN CENTER, MN 55430

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1780755256, enumerated as an "individual" on November 13, 2006.

The provider is located at 6200 SHINGLE CREEK PKWY STE 350 BROOKLYN CENTER, MN 55430 and the phone number is (763) 503-8560.

Psychologist with taxonomy code 103TC0700X and a focus in Clinical.

The provider might be accepting Accepts: HealthPartners, Providence Health Plan, Medicare,. Please consult your insurance carrier or call the provider to verify.