Heron Ridge Associates, PLC

Primary specialty

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

License

631112 Issued in MI

Legal business name

HERON RIDGE ASSOCIATES, PLC

Practice address

1785 W Stadium Blvd Ste 205
Ann Arbor, MI 48103-5285

Phone

(734) 454-3560

Fax

(248) 391-7478

NPI assigned

Mar 12, 2008

Last updated

Dec 30, 2022By the provider in NPPES

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": "1740450279",
    "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": "1785 W STADIUM BLVD STE 205",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481035285",
            "telephone_number": "734-454-3560",
            "fax_number": "248-391-7478"
        }
    ],
    "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": "631112",
            "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": "750910606",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ramiro Hernandez, MD
• Sarah Elizabeth Hernandez, RN
• Kenyatta Herndon, CNM
• Andrew Spencer Herner
• Heron Ridge Associates PLC
• Holli Herr, MA
• Reid Marcial Herran
• Lindsey Allison Herrel, M.D.
• Brenda Herrera-Reed, MD
• Jonathan Joseph Herrera, MD, PHD

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