Provider Demographics
NPI:1578285375
Name:HERNER, ERIN
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:HERNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3724 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64109-2752
Mailing Address - Country:US
Mailing Address - Phone:816-875-5082
Mailing Address - Fax:
Practice Address - Street 1:800 E 101ST TER STE 350B
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64131-5322
Practice Address - Country:US
Practice Address - Phone:816-875-5082
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-19
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2022016625101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional