Provider Demographics
NPI:1346640026
Name:HERMES, ANGELYNN (LCSW)
Entity Type:Individual
Prefix:
First Name:ANGELYNN
Middle Name:
Last Name:HERMES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 COLORADO BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90041-1733
Mailing Address - Country:US
Mailing Address - Phone:213-275-2200
Mailing Address - Fax:213-275-2220
Practice Address - Street 1:850 COLORADO BLVD STE 102
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90041
Practice Address - Country:US
Practice Address - Phone:213-275-2200
Practice Address - Fax:213-275-2220
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-29
Last Update Date:2019-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA889971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty