NPIMap

Organization Active NPI

Optum Behavioral Care of Colorado, P.C.

Doing business as Heron Ridge Associates of Michigan

  • Clinical Psychologist
  • Plymouth, MI
National Provider Identifier
1306616735
Registry record updated Aug 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
OPTUM BEHAVIORAL CARE OF COLORADO, P.C.
Doing business as
Heron Ridge Associates of Michigan
Practice address
705 S Main St Ste 280
Plymouth, MI 48170-1060
Phone
(734) 454-3560
NPI assigned
Jan 5, 2024
Last updated
Aug 6, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2026

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

Authorized official

Name
Amanda Stacey BronsonNPI 1043591167
Title
Dir Gen MGMT
Phone
(978) 222-3121

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X Primary

Addresses

Primary practice location

705 S Main St Ste 280
Plymouth, MI 48170-1060

Mailing address

11000 Optum Cir
Eden Prairie, MN 55344-2503
Phone (248) 594-4991

Other practice location 1

5841 Whitmore Lake Rd Ste A
Brighton, MI 48116-1991
Phone (734) 454-3560

Other practice location 2

31000 Telegraph Rd Ste 120
Bingham Farms, MI 48025-4321
Phone (248) 594-4991

Other practice location 3

3300 Washtenaw Ave Ste 265
Ann Arbor, MI 48104-4200
Phone (734) 822-4810

Other practice location 4

1785 W Stadium Blvd Ste 205
Ann Arbor, MI 48103-5285
Phone (734) 913-1093

Other names 1

  • Heron Ridge Associates of Michigan Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240412001576 MI Part B Supplier - Clinic/Group Practice 0941648463 Receives reassigned benefits from 25 practitioners
1 other NPI on this enrollment
Practice locations: Ann Arbor, MI; Bingham Farms, MI; Brighton, MI; Plymouth, MI

Other NPIs with the same Medicare PAC ID 12

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 26

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1704412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785974400000",
    "number": "1306616735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11000 OPTUM CIR",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553442503",
            "telephone_number": "248-594-4991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 S MAIN ST STE 280",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481701060",
            "telephone_number": "734-454-3560"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5841 Whitmore Lake Rd Ste A",
            "address_purpose": "LOCATION",
            "city": "Brighton",
            "state": "MI",
            "postal_code": "481161991",
            "country_code": "US",
            "telephone_number": "734-454-3560",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "31000 Telegraph Rd Ste 120",
            "address_purpose": "LOCATION",
            "city": "Bingham Farms",
            "state": "MI",
            "postal_code": "480254321",
            "country_code": "US",
            "telephone_number": "248-594-4991",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3300 Washtenaw Ave Ste 265",
            "address_purpose": "LOCATION",
            "city": "Ann Arbor",
            "state": "MI",
            "postal_code": "481044200",
            "country_code": "US",
            "telephone_number": "734-822-4810",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1785 W Stadium Blvd Ste 205",
            "address_purpose": "LOCATION",
            "city": "Ann Arbor",
            "state": "MI",
            "postal_code": "481035285",
            "country_code": "US",
            "telephone_number": "734-913-1093",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "OPTUM BEHAVIORAL CARE OF COLORADO, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-05",
        "last_updated": "2026-08-06",
        "certification_date": "2026-08-06",
        "status": "A",
        "authorized_official_last_name": "BRONSON",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_middle_name": "STACEY",
        "authorized_official_title_or_position": "DIR GEN MGMT",
        "authorized_official_telephone_number": "978-222-3121"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heron Ridge Associates of Michigan",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Plymouth, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2026; 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.