Heritage Care Place LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

HERITAGE CARE PLACE LLC

Practice address

135 Eagles Walk Ste 100
Stockbridge, GA 30281-7205

Phone

(470) 726-4147

NPI assigned

Apr 26, 2024

Organization subpart

No

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

Authorized official

Name

Mr. Victor Akinola

Title

Owner

Phone

(470) 726-4147

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Brittany Griffin

  • Clinical Neuropsychologist
  • Alpharetta, GA
  • NPI 1336496512
  Medicare reassignment NPD
• Adrienne Johnson, LCSW

  • Clinical Social Worker
  • Conyers, GA
  • NPI 1811271737
  Medicare reassignment NPD
• Fatima Elizabeth Kasiah, M.D.

  • Psychiatry Physician
  • Atlanta, GA
  • NPI 1750680278
  Medicare reassignment NPD
• Shakeva Tiller, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Stockbridge, GA
  • NPI 1255117271
  Medicare reassignment NPD
• Cosha Shawntell Joseph, MS, LPC

  • Professional Counselor
  • Houston, TX
  • NPI 1457720237

  GA, Mental Health

  Medicare reassignment NPD

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

{
    "created_epoch": "1714089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722816000000",
    "number": "1124874425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 EAGLES WALK STE 100",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817205",
            "telephone_number": "470-726-4147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 EAGLES WALK STE 100",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817205",
            "telephone_number": "470-726-4147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE CARE PLACE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-26",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A",
        "authorized_official_last_name": "AKINOLA",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "470-726-4147",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nickson Henry, O.D.
• Shane L Henry
• Henry'S Home Care Services, LLC
• Kathlene Herbermann, AA
• Here 4 U Lifestyle Management
• Howard Kenneth Herman, M.D.
• Patricia A Herrmann, D.C.
• Blair Elizabeth Herrod, MSOT, OTR/L
• Benjamin Herron III
• Regener L Herron

• Professional Counselor in Stockbridge, GA
• Providers in Stockbridge, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.