npidexNPI registry + Medicare data

ERICH HAEZEBROUCK, PSYD

Psychologist · WHEAT RIDGE, CO

Individual Active Opted out of Medicare NPI 1194006296

Taxonomy & licensure

SpecialtyCodePrimaryLicenseState
Psychologist103T00000X✓32789CA
Mental Health Counselor101YM0800X——

Medicare eligibility

Part B
Yes
DME
Yes
Home health
No
Power mobility
No
Hospice
No

Opted out of Medicare (Clinical Psychologist), effective 2022-04-19 through 2028-04-19.

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Source: NPPES (public domain) and CMS Medicare Physician & Other Practitioners data. Not affiliated with CMS, NPPES, or any government agency.