Provider Demographics
NPI:1326255886
Name:HERMAN, DEIRDRE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:DEIRDRE
Middle Name:
Last Name:HERMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:DEIRDRE
Other - Middle Name:
Other - Last Name:MCCOURT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:304 OLD BRIDGE RD.
Mailing Address - Street 2:
Mailing Address - City:BRIELLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08730
Mailing Address - Country:US
Mailing Address - Phone:732-528-1365
Mailing Address - Fax:732-528-4656
Practice Address - Street 1:304 OLD BRIDGE RD.
Practice Address - Street 2:
Practice Address - City:BRIELLE
Practice Address - State:NJ
Practice Address - Zip Code:08730
Practice Address - Country:US
Practice Address - Phone:732-528-1365
Practice Address - Fax:732-528-4656
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2012-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC045003001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical