Individual provider Active NPI

Bradley Hieger, PH.D., L.P.C.

  • Psychologist
  • Cumming, GA
National Provider Identifier
1740355288
Registry record updated Sep 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY003603 Issued in GA
Practice address
5975 Parkway North Blvd
Suite 300 D
Cumming, GA 30040-1226
Phone
(404) 388-3909
Fax
(678) 712-1945
NPI assigned
Nov 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LPC005028 GA
Psychologist 103T00000X PSY003603 GA Primary
Counseling Psychologist 103TC1900X PSY003603 GA

Addresses

Primary practice location

5975 Parkway North Blvd
Suite 300 D
Cumming, GA 30040-1226

Mailing address

5975 Parkway North Blvd
Suite 300 D
Cumming, GA 30040-1226
Phone (404) 388-3909

Other identifiers 1

IdentifierTypeStateIssuer
883083592AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
LPC005028GAMDMental Health Counselor
PSY003603GAMDCounseling Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Focus Forward Counseling and Consulting, Inc CurrentSince Jul 15, 2015 Accepting new patients

Locations

5975 Parkway North Blvd
Ste 300D
Cumming, GA 30040
Phone (404) 388-3909

5975 Parkway North Blvd
Ste D
Cumming, GA 30040
Phone (404) 388-3909

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347926400000",
    "number": "1740355288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5975 PARKWAY NORTH BLVD",
            "address_2": "SUITE 300 D",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300401226",
            "telephone_number": "404-388-3909",
            "fax_number": "678-712-1945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5975 PARKWAY NORTH BLVD",
            "address_2": "SUITE 300 D",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300401226",
            "telephone_number": "404-388-3909",
            "fax_number": "678-712-1945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIEGER",
        "first_name": "BRADLEY",
        "name_prefix": "Dr.",
        "credential": "PH.D., L.P.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2012-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "LPC005028",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "GA",
            "license": "PSY003603",
            "primary": true
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "GA",
            "license": "PSY003603",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "883083592A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumming, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2012; 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.