Provider Demographics
NPI:1275540650
Name:HERRMANN, JOHN H JR (LMHC)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:H
Last Name:HERRMANN
Suffix:JR
Gender:M
Credentials:LMHC
Other - Prefix:MR
Other - First Name:JACK
Other - Middle Name:
Other - Last Name:HERRMANN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMHC
Mailing Address - Street 1:147 AVALON DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-2217
Mailing Address - Country:US
Mailing Address - Phone:585-454-1105
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY OF ROCHESTER MEDICAL CTR
Practice Address - Street 2:300 CRITTENDEN BLVD., BOX PSYCHIATRY
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14642-0001
Practice Address - Country:US
Practice Address - Phone:585-275-6740
Practice Address - Fax:585-276-0307
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000789101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health