Heron Ridge Associates, PLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

License

631056 Issued in MI

Legal business name

HERON RIDGE ASSOCIATES, PLC

Practice address

31000 Telegraph Rd
Suite 120
Bingham Farms, MI 48025-4360

Phone

(248) 594-4991

Fax

(248) 391-7478

NPI assigned

Mar 12, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Elliott Richelson, M.D.

Title

President, Secretary, Treasurer

Phone

(904) 605-4986

Specialties & licenses 1

Addresses

Other identifiers 2

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1205280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672358400000",
    "number": "1013187541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3694 CLARKSTON RD",
            "address_2": "SUITE D",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483485213",
            "telephone_number": "248-693-8880",
            "fax_number": "248-391-7478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31000 TELEGRAPH RD",
            "address_2": "SUITE 120",
            "city": "BINGHAM FARMS",
            "state": "MI",
            "postal_code": "480254360",
            "telephone_number": "248-594-4991",
            "fax_number": "248-391-7478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERON RIDGE ASSOCIATES, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-12",
        "last_updated": "2022-12-30",
        "certification_date": "2022-12-30",
        "status": "A",
        "authorized_official_last_name": "RICHELSON",
        "authorized_official_first_name": "ELLIOTT",
        "authorized_official_title_or_position": "PRESIDENT, SECRETARY, TREASURER",
        "authorized_official_telephone_number": "904-605-4986",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "MI",
            "license": "631056",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "463240",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "750910409",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Heritage Labs, Inc.
• Heritage Labs, Inc.
• Raquel Hernandez-Snyder
• Kassandra Hernandez
• Heron Ridge Associates PLC
• Troy Ray Herrick-Thomason
• Kiara Parshel Herrick
• Dejanae Latia Herriote-Ruseell
• Nakya D Herriotte
• Allison Hess

• Mental Health Clinic/Center (Including Community Mental Health Center) in Bingham Farms, MI
• Providers in Bingham Farms, MI by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.