Andrew Philip Heidesch, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MFT001048 Issued in GA

Practice address

1361 Jennings Mill Road
Suite 201
Bogart, GA 30622

Phone

(706) 316-1908

Fax

(706) 316-2062

NPI assigned

Apr 4, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Athens Behavioral Medicine

  • Psychiatry Physician
  • Bogart, GA
  • NPI 1902026347
  NPD (past)

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760504641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 JENNINGS MILL PARKWAY",
            "address_2": "#538",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "30606",
            "telephone_number": "706-254-4867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1361 JENNINGS MILL ROAD",
            "address_2": "SUITE 201",
            "city": "BOGART",
            "state": "GA",
            "postal_code": "30622",
            "telephone_number": "706-316-1908",
            "fax_number": "706-316-2062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEIDESCH",
        "first_name": "ANDREW",
        "middle_name": "PHILIP",
        "name_prefix": "Mr.",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "GA",
            "license": "MFT001048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel W Hamil, MD
• Kathleen Hamilton
• Hampton Valley Health Center, Inc.
• Christine S Harr, FNP-C
• Phyllis Denise Haynes
• Jana Heitmeyer, RD, CSSD, LD, CSCS
• Angela Held, PT, DPT
• HMP Diagnostics, LLC
• Home Medical Professionals
• Kimberly Horner, LMSW

• All providers in Bogart, GA
• Marriage & Family Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.