MEDICARE: KATHERINE HEFFELFINGER, MA, LP, P.A.

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	LP#3339	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	9H397LA	OTHER	MN	BLUE CROSS/BLUE SHIELD MN
2	106178 (GROUP#)	OTHER	MN	HEALTH PARTNERS
3	62-81933 (GROUP#)	OTHER	MN	UHC MEDICA CHOICE

General Provider Information

NPI Number	:	1952404121
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KATHERINE HEFFELFINGER, MA, LP, P.A.

Provider Business Mailing Address
First Line	:	4650 FRANCE AVE S
Second Line	:
City	:	EDINA
State	:	MN
Zip	:	55410-1752
Country	:	US
Telephone Number	:	952-848-7489
Fax Number	:	952-848-0597

Provider Business Practice Location Address
First Line	:	4650 FRANCE AVE S
Second Line	:
City	:	EDINA
State	:	MN
Zip	:	55410-1752
Country	:	US
Telephone Number	:	952-848-7489
Fax Number	:	952-848-0597

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. KATHERINE HEFFELFINGER
Credential	:	MA, LP
Telephone Number	:	952-848-7489

Provider Enumeration Date	:	09/06/2006
Last Update Date	:	08/22/2020

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