MEDICARE: HERO HOUSE PHYSICIANS GROUP LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TP2701X	Group Psychotherapy Psychologist

General Provider Information

NPI Number	:	1316213101
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HERO HOUSE PHYSICIANS GROUP LLC

Provider Business Mailing Address
First Line	:	510 GLENGATE CV
Second Line	:
City	:	SANDY SPRINGS
State	:	GA
Zip	:	30328-7255
Country	:	US
Telephone Number	:	949-215-5795
Fax Number	:

Provider Business Practice Location Address
First Line	:	1318 SHILOH TRAIL EAST NW
Second Line	:
City	:	KENNESAW
State	:	GA
Zip	:	30144-2044
Country	:	US
Telephone Number	:	949-215-5795
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	RANDY HAVESON
Credential	:
Telephone Number	:	949-215-5796

Provider Enumeration Date	:	03/27/2012
Last Update Date	:	01/27/2014

Similar Medicare Providers

1134865504 — SAAD GULIWALA
Practice Location Address:

2112 OLD 41 HWY NW
KENNESAW, GA
30144-3793

Practice Phone: 678-269-7099
Practice Fax:

1235740861 — JONESSE LOVE
Practice Location Address:

2914 CHEROKEE ST NW STE 1A
KENNESAW, GA
30144-6526

Practice Phone: 678-369-4268
Practice Fax:

1215653746 — MILLINI JOHNETTE JOHNSON LPC
Practice Location Address:

4255 WADE GREEN RD NW STE 414
KENNESAW, GA
30144-1763

Practice Phone: 678-213-2194
Practice Fax: 678-922-7767

1346061959 — NATALIE HOPE SIZER LPC
Practice Location Address:

4255 WADE GREEN RD NW STE 414
KENNESAW, GA
30144-1763

Practice Phone: 678-213-2194
Practice Fax: 678-922-7767

1861295990 — BREYANNA PATTERSON
Practice Location Address:

3330 CHASTAIN MEADOWS PKWY NW STE 200
KENNESAW, GA
30144-5881

Practice Phone: 678-648-7644
Practice Fax:

1427745280 — MARK NOH DDS
Practice Location Address:

3420 ACWORTH DUE WEST RD NW
KENNESAW, GA
30144-2371

Practice Phone: 213-407-2557
Practice Fax:

Directions to “HERO HOUSE PHYSICIANS GROUP LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.