MEDICARE: JODI DEANNE LINDLEY HERMAN LMHC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor	CG61310577	WA
2	101YM0800X	Mental Health Counselor	MC61460499	WA
3	101YM0800X	Mental Health Counselor	MHC.LH.70033076	WA

General Provider Information

NPI Number	:	1194463364
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JODI DEANNE LINDLEY HERMAN LMHC

Provider Business Mailing Address
First Line	:	10003 N DIVISION ST STE 205
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99218-1386
Country	:	US
Telephone Number	:	509-838-4651
Fax Number	:	509-720-7468

Provider Business Practice Location Address
First Line	:	10003 N DIVISION ST STE 205
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99218-1386
Country	:	US
Telephone Number	:	509-720-7468
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/26/2022
Last Update Date	:	02/03/2026

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