Healthcare Provider Details

I. General information

NPI: 1801817077
Provider Name (Legal Business Name): KAREN S HERMANN PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2006
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1611 W CENTRE AVE STE 212
PORTAGE MI
49024-5344
US

IV. Provider business mailing address

9677 FIREFLY AVE
GALESBURG MI
49053-9700
US

V. Phone/Fax

Practice location:
  • Phone: 269-220-1252
  • Fax: 269-585-6255
Mailing address:
  • Phone: 269-779-5630
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number6301012960
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number6301012960
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: