Heron Ridge Associates PLC

Primary specialty

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

License

822246 Issued in MI

Legal business name

HERON RIDGE ASSOCIATES PLC

Practice address

705 S Main St
Suite 280
Plymouth, MI 48170-2089

Phone

(734) 454-3560

Fax

(734) 454-3570

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": "1295905727",
    "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": "705 S MAIN ST",
            "address_2": "SUITE 280",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481702089",
            "telephone_number": "734-454-3560",
            "fax_number": "734-454-3570"
        }
    ],
    "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": "822246",
            "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": "750910408",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda Hernandez
• Liliana Hernandez
• Linda Hernandez
• Lizzette Hernandez
• Sergio Hernandez
• Heron Ridge Associates, PLC
• Gonzalo Herradon
• Skyelar Herriman
• Lianiece Herring
• Starr Herron

• Mental Health Clinic/Center (Including Community Mental Health Center) in Plymouth, MI
• Providers in Plymouth, 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.