Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 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 Not confirmed with CMS for 14 years — call before visiting
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

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

Colleagues at Nystrom and Associates Ltd

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 617 clinicians in the practice; 12 are shown here.

Other providers in New Brighton