MEDICARE: MR. COLIN MICHAEL HEGLUND M.A., LP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	LP5248	MN

General Provider Information

NPI Number	:	1154511905
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. COLIN MICHAEL HEGLUND M.A., LP

Provider Business Mailing Address
First Line	:	1741 15TH ST NW
Second Line	:	PO BOX 744
City	:	BEMIDJI
State	:	MN
Zip	:	56601-8755
Country	:	US
Telephone Number	:	218-751-6553
Fax Number	:	218-751-1846

Provider Business Practice Location Address
First Line	:	4225 TECHNOLOGY DR NW
Second Line	:
City	:	BEMIDJI
State	:	MN
Zip	:	56601-5118
Country	:	US
Telephone Number	:	218-751-0282
Fax Number	:	218-751-0870

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/27/2007
Last Update Date	:	05/19/2026

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