Heidi Jo Hathaway
PSYD, LP | Clinical Psychologist | 30+ years Exp
6200 Shingle Creek Pkwy Ste 350, Brooklyn Center
Minnesota, 55430-2155
763-503-8560 763-503-8563
Maps & DirectionsHeidi Jo Hathaway is a Brooklyn Center, Minnesota based psychologist with 30 years of experience in Clinical Psychology. She completed her graduation in 1996. She accepts the Medicare-approved amount. Patients will not be billed for any more than the Medicare deductible and coinsurance. Active license number of Heidi Jo Hathaway is LP3930 for Clinical Psychology in Minnesota. Her current practice location is 6200 Shingle Creek Pkwy Ste 350, Brooklyn Center. Patients can reach her at 763-503-8560 or can fax her at 763-503-8563. Heidi Jo Hathaway is PSYD, LP in Clinical Psychology and her NPI number (Unique professional ID assigned by NPPES) is 1780755256.
Heidi Jo Hathaway is a mental health professional with highly specialized training in the diagnosis and psychological treatment of mental, behavioral and emotional illnesses, including obsessive-compulsive disorder (OCD). Her main focus is on diagnosing and treating mental, emotional, and behavioral disorders. Some of the common disorders that she can treat are learning disabilities, substance abuse, depression, anxiety, and eating disorders.
Complete Profile:
Heidi Jo Hathaway speciality, credentials, practice address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointment.
| Name: | Heidi Jo Hathaway |
| Specialization: | Clinical Psychology |
| Gender: | Female |
| Credentials: | PSYD, LP |
| Experience: | 30+ years |
| Medical School Attended: | Other |
| Graduation Year: | 1996 |
| Accepts Medicare Assignment: | Yes |
| Practice Address: | 6200 Shingle Creek Pkwy Ste 350, Brooklyn Center,
Minnesota, 55430-2155 |
| Phone: | 763-503-8560 |
| Fax: | 763-503-8563 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
| PAC ID: | 6204902240 |
| Enrollment ID: | I20080827000592 |
| NPI Number: | 1780755256 |
| NPI Enumeration Date: | 13 Nov, 2006 |
| NPI Last Update On: | 02 Feb, 2023 |
Medical Licenses:
Doctors can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Heidi Jo Hathaway are as mentioned below.
| License Number | Specialization | State | Status | |
| LP3930 | Clinical Psychology | Minnesota | Primary | |
Group Practice:
Group practices are practice of medicine by a group of physicians who share their premises and other resources. Following list states all the group name
with which Heidi Jo Hathaway is associated with along with the number of members in that group.
| Organization Name (Group PAC ID) | Members |
| Nystrom And Associates Ltd (6406752492) | 172 |
Other Medical Identifiers:
Other legacy medical identifiers associated with Heidi Jo Hathaway such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 123494 | Other | Minnesota | UCARE |
| 61-34863 | Other | Minnesota | MEDICA |
| 050385100 | Medicaid | | |
| 11R21RE | Other | Minnesota | BLUECROSSBLUESHIELD |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Heidi Jo Hathaway
4240 Park Glen Rd,
St Louis Park, Minnesota |
| Zip: | 55416-5427 |
| Phone Number: | 612-925-6033 |
| Fax Number: | 612-925-8496 |
Patients can reach Heidi Jo Hathaway at
6200 Shingle Creek Pkwy Ste 350, Brooklyn Center, Minnesota or can
call to book an appointment on 763-503-8560.
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Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 December, 2025.