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General NPI Number Information
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NPI Number | 1437487014
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Entity Type | Individual
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Provider Name | IVAN MICHAEL HERRERA M.A
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Gender | Male
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Dates
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Enumeration Date | 11/19/2009
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 100 SPRINGHOUSE CT STE 200
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City | HENDERSONVILLE
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State | TN
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Zip | 37075-1610
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Country | US
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Telephone | 865-588-3173
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Fax |
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Provider Business Mailing Address
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Address Line | 4800 N SCOTTSDALE RD STE 2500
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City | SCOTTSDALE
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State | AZ
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Zip | 85251-7630
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Country | US
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Telephone | 865-588-3173
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 3511
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License Number State | TN
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