MEDICARE: DR. KRISTEN GHERSI HERING PH.D.

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	103T00000X	Psychologist

General Provider Information

NPI Number	:	1568943181
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KRISTEN GHERSI HERING PH.D.

Provider Business Mailing Address
First Line	:	41000 WOODWARD AVE STE 386
Second Line	:
City	:	BLOOMFIELD HILLS
State	:	MI
Zip	:	48304-5130
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	41000 WOODWARD AVE
Second Line	:
City	:	BLOOMFIELD HILLS
State	:	MI
Zip	:	48304-5130
Country	:	US
Telephone Number	:	248-955-5699
Fax Number	:

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

Provider Enumeration Date	:	08/22/2018
Last Update Date	:	03/27/2026

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