Healthcare Provider Details

I. General information

NPI: 1427464924
Provider Name (Legal Business Name): SHEILA HERMES M.ED., LPCC, LADC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2014
Last Update Date: 07/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11549 LAKE LN SUITE 2
CHISAGO CITY MN
55013-9830
US

IV. Provider business mailing address

11549 LAKE LN SUITE 2
CHISAGO CITY MN
55013-9830
US

V. Phone/Fax

Practice location:
  • Phone: 651-257-2733
  • Fax: 651-257-2783
Mailing address:
  • Phone: 651-257-2733
  • Fax: 651-257-2783

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number300524
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberCC00789
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: