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Heidi Jo Hathaway, PSYD,LP
Clinical Psychologist in Brooklyn Center, Minnesota
NPI 1780755256

Heidi Jo Hathaway is a Clinical Psychologist based in St Louis Park, MN and is specialized in Clinical. Heidi Jo Hathaway practices in Brooklyn Center, MN and has the professional credentials of PSYD,LP. The NPI Number for Heidi Jo Hathaway is 1780755256 and holds a License No. LP3930 (Minnesota).

The current practice location address for Heidi Jo Hathaway is 6200 Shingle Creek Pkwy Ste 350, Brooklyn Center, MN and can be reached out via phone at 763-503-8560 and via fax at 763-503-8563. You can also correspond with Heidi Jo Hathaway through the mailing address at 4240 PARK GLEN RD, ST LOUIS PARK, MN - 55416-5427 (mailing address contact number: 612-925-6033).

Location: 6200 Shingle Creek Pkwy Ste 350, Brooklyn Center, MN, 55416-5427
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1780755256
Provider Name
Heidi Jo Hathaway
Credential
PSYD,LP
Provider Entity Type
Individual
Gender
Female
Address
6200 Shingle Creek Pkwy Ste 350, Brooklyn Center, MN, 55416-5427
Phone Number
763-503-8560
Fax Number
763-503-8563
Provider Enumeration Date
11/13/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
123494 01 MN UCARE
61-34863 01 MN MEDICA
050385100 05 FM
11R21RE 01 MN BLUECROSSBLUESHIELD
institution
Provider Business Practice Location Address Details
Address
6200 Shingle Creek Pkwy Ste 350
City
Brooklyn Center
State
Minnesota
Zip
55430-2155
Phone Number
763-503-8560
Fax Number
763-503-8563
person
Provider Business Mailing Address Details
Address
6200 Shingle Creek Pkwy Ste 350
City
Brooklyn Center
State
Minnesota
Zip
55430-2155
Phone Number
763-503-8560
Fax Number
763-503-8563
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Psychologist
Speciality
Clinical
Taxonomy
103TC0700X
License No.
LP3930 (Minnesota)
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.
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