MEDICARE: DR. STEPHEN BERNARD HEILMAN JR. EDD PSYCHOLOGY

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	103T00000X	Psychologist	3131	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	113338	OTHER	MHN
2	024746	OTHER	UMC
3	026053000	OTHER	MAGELLAN
4	000000015675	OTHER	ANTHEM
5	280210	OTHER	VALUE OPTIONS
6	1216946	OTHER	CHA
7	9906430	OTHER	OHIO BUREAU WORKERS COMP

General Provider Information

NPI Number	:	1396851929
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHEN BERNARD HEILMAN JR. EDD PSYCHOLOGY

Provider Business Mailing Address
First Line	:	9900 CINCINNATI COLUMBUS RD
Second Line	:
City	:	WEST CHESTER
State	:	OH
Zip	:	45241-1209
Country	:	US
Telephone Number	:	513-779-9955
Fax Number	:	513-779-0160

Provider Business Practice Location Address
First Line	:	9900 CINCINNATI COLUMBUS RD
Second Line	:
City	:	WEST CHESTER
State	:	OH
Zip	:	45241-1209
Country	:	US
Telephone Number	:	513-779-9955
Fax Number	:	513-779-0160

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

Provider Enumeration Date	:	08/23/2006
Last Update Date	:	09/02/2020

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Directions to “ DR. STEPHEN BERNARD HEILMAN JR. EDD PSYCHOLOGY” Practice Location

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