Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Heidi Jo Hathaway, PSYD, LP

Individual provider Clinical Psychologist · NPI 1780755256

Heidi Jo Hathaway, PSYD, LP is a Clinical Psychologist in Brooklyn Center, Minnesota. Qualified in 1996, 30 years ago. Practices with Associated Clinic of Psychology Inc, a 137-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Minnesota.

Years since qualifying
30
Licensed in
MN
In the registry since
2006
What do these letters mean?
PSYD — Doctor of Psychology
A doctoral psychologist trained primarily for clinical practice.

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Practice location Address checks out

6200 Shingle Creek Pkwy Ste 350
Brooklyn Center, MN 55430-2155
Phone: (763) 503-8560
Fax: (763) 503-8563
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 4027 County Road 25, Minneapolis, MN 55416-2629 — (612) 925-6033

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence LP3930 (MN)

Record details

NPI number1780755256
Entity typeIndividual (Type 1)
GenderFemale
Credentials PSYD , LP
Sole proprietorNo
NPI enumeratedNovember 13, 2006
Last updated in NPPESFebruary 2, 2023
Certification dateFebruary 2, 2023

Medicare enrollment

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

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 1996 (30 years in practice)
Group practice Associated Clinic Of Psychology Inc — 137 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Brooklyn Center