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General NPI Number Information
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NPI Number | 1962600510
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Entity Type | Organization
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Legal Business Name | CHRISTINE HERMAN ACSW LCSW LLC
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Dates
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Enumeration Date | 07/05/2007
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Last Update Date | 10/15/2007
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Provider Practice Location Address
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Address Line | 570 MEMORIAL CIR SUITE 310
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City | ORMOND BEACH
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State | FL
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Zip | 32174-5002
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Country | US
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Telephone | 386-672-7274
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Fax |
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Provider Business Mailing Address
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Address Line | 570 MEMORIAL CIR SUITE 310
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City | ORMOND BEACH
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State | FL
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Zip | 32174-5002
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Country | US
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Telephone | 386-672-7274
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Fax |
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Authorized Official
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Title or Position | LICENSED CLINICAL SOCIAL WORKER
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Name | CHRISTINE BARBARA HERMAN
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Credential | ACSW LCSW
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Telephone | 386-672-7274
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW5932
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License Number State | FL
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