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General NPI Number Information
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NPI Number | 1831388826
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Entity Type | Organization
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Legal Business Name | JOHN W. HERDMAN, PH.D., PC
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Dates
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Enumeration Date | 10/16/2007
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Last Update Date | 10/28/2019
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Provider Practice Location Address
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Address Line | 1640 L ST STE C
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City | LINCOLN
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State | NE
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Zip | 68508-2581
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Country | US
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Telephone | 402-489-9792
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Fax | 402-489-9793
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Provider Business Mailing Address
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Address Line | 4706 S 48TH ST
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City | LINCOLN
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State | NE
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Zip | 68516-1276
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Country | US
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Telephone | 402-489-9792
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Fax | 402-489-9793
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | DR. JOHN W HEDMAN
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Credential | PH.D.
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Telephone | 402-489-9792
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Psychologist
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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 | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number |
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License Number State |
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