Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Heather Bodurtha

Individual provider Clinical Psychologist · NPI 1679774673

Heather Bodurtha is a Clinical Psychologist in New Brighton, Minnesota. Qualified in 2004, 22 years ago. Practices with Nystrom and Associates Ltd, a 617-clinician group and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying
22
Licensed in
MN
In the registry since
2007
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Practice location Address checks out

1900 Silver Lake Rd NW 110
New Brighton, MN 55112-1786
Phone: (651) 628-9566
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence LP4705 (MN)

Record details

NPI number1679774673
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMay 29, 2007
Last updated in NPPESOctober 10, 2012
Mailing address1900 Silver Lake Rd Nw, 110, New Brighton, MN 55112-1786

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 2004 (22 years in practice)
Group practice Nystrom And Associates Ltd — 617 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in New Brighton