Healthcare Provider Details

I. General information

NPI: 1477215721
Provider Name (Legal Business Name): KATHERINE ROSE HERRMANN LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2021
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4565 DRESSLER RD NW STE 112
CANTON OH
44718-2576
US

IV. Provider business mailing address

7547 MENTOR AVE STE 306
MENTOR OH
44060-5432
US

V. Phone/Fax

Practice location:
  • Phone: 330-765-5160
  • Fax: 440-527-8043
Mailing address:
  • Phone: 440-701-6170
  • Fax: 440-527-8043

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.2613793
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: