Provider Demographics
NPI:1689347817
Name:HERMANN PSYCHOLOGICAL SERVICES LLC
Entity type:Organization
Organization Name:HERMANN PSYCHOLOGICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:HERMANN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:269-220-1252
Mailing Address - Street 1:9677 FIREFLY AVE
Mailing Address - Street 2:
Mailing Address - City:GALESBURG
Mailing Address - State:MI
Mailing Address - Zip Code:49053-9700
Mailing Address - Country:US
Mailing Address - Phone:269-779-5630
Mailing Address - Fax:
Practice Address - Street 1:5955 W MAIN ST STE 206
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49009-9266
Practice Address - Country:US
Practice Address - Phone:269-220-1252
Practice Address - Fax:269-585-6255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-25
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty