NPIMap

Organization Active NPI

Heron Healing Therapy Practice PLLC

  • Clinical Social Worker
  • Dearborn, MI
National Provider Identifier
1598448771
Registry record updated Aug 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
HERON HEALING THERAPY PRACTICE PLLC
Practice address
15350 N Commerce Dr Ste 204
Dearborn, MI 48120-1234
Phone
(248) 871-7042
NPI assigned
Aug 14, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2023

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

Authorized official

Name
Yannick AlexisNPI 1669150926
Title
Member
Phone
(301) 256-4826

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

15350 N Commerce Dr Ste 204
Dearborn, MI 48120-1234

Mailing address

15350 N Commerce Dr Ste 204
Dearborn, MI 48120-1234

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1691971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691971200000",
    "number": "1598448771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15350 N COMMERCE DR STE 204",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481201234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15350 N COMMERCE DR STE 204",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481201234",
            "telephone_number": "248-871-7042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERON HEALING THERAPY PRACTICE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-14",
        "last_updated": "2023-08-14",
        "certification_date": "2023-08-13",
        "status": "A",
        "authorized_official_last_name": "ALEXIS",
        "authorized_official_first_name": "YANNICK",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "301-256-4826"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2023; 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.