MEDICARE: ALEXIS HERMAN, PSYD L.L.C.

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	103TC0700X	Clinical Psychologist

General Provider Information

NPI Number	:	1912638370
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALEXIS HERMAN, PSYD L.L.C.

Provider Business Mailing Address
First Line	:	1600 WILSON BLVD STE 702
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22209-2505
Country	:	US
Telephone Number	:	202-656-1008
Fax Number	:

Provider Business Practice Location Address
First Line	:	1600 WILSON BLVD STE 702
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22209-2505
Country	:	US
Telephone Number	:	202-656-1008
Fax Number	:

Authorized Official
Title or Position	:	CONTRACTOR
Name	:	JULIA DOWNER
Credential	:
Telephone Number	:	571-296-9792

Provider Enumeration Date	:	06/17/2022
Last Update Date	:	08/22/2022

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