Healthcare Provider Details

I. General information

NPI: 1609706191
Provider Name (Legal Business Name): HEATHER S RICHARDSON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HUNTINGTON RD STE 801
ATHENS GA
30606-7216
US

IV. Provider business mailing address

1 HUNTINGTON RD STE 801
ATHENS GA
30606-7216
US

V. Phone/Fax

Practice location:
  • Phone: 706-552-0450
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. HEATHER SMITH RICHARDSON
Title or Position: OWNER
Credential: PSYD
Phone: 912-342-3144