Healthcare Provider Details

I. General information

NPI: 1477469005
Provider Name (Legal Business Name): JORDEN HERRLY MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2026
Last Update Date: 08/22/2026
Certification Date: 08/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51 E 3RD ST # 201
WINONA MN
55987-3447
US

IV. Provider business mailing address

51 E 3RD ST # 201
WINONA MN
55987-3447
US

V. Phone/Fax

Practice location:
  • Phone: 507-860-4239
  • Fax:
Mailing address:
  • Phone: 507-860-4239
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: