Provider Demographics
NPI:1316018609
Name:HERMAN, LINDA MARIE (MED, EDS, LMHC)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:MARIE
Last Name:HERMAN
Suffix:
Gender:F
Credentials:MED, EDS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11126 SE 256TH ST
Mailing Address - Street 2:BUILDING 0, SUITE 206
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98030-5633
Mailing Address - Country:US
Mailing Address - Phone:253-859-2507
Mailing Address - Fax:253-859-0975
Practice Address - Street 1:11126 SE 256TH ST
Practice Address - Street 2:BUILDING 0, SUITE 206
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98030-5633
Practice Address - Country:US
Practice Address - Phone:253-859-2507
Practice Address - Fax:253-859-0975
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00005427101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health