Provider Demographics
NPI:1578516332
Name:HERL, LARRY LYNN
Entity Type:Individual
Prefix:MR
First Name:LARRY
Middle Name:LYNN
Last Name:HERL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8615 MEADVILLE RD
Mailing Address - Street 2:
Mailing Address - City:GIRARD
Mailing Address - State:PA
Mailing Address - Zip Code:16417-9225
Mailing Address - Country:US
Mailing Address - Phone:814-774-9107
Mailing Address - Fax:
Practice Address - Street 1:131 E STATE ST
Practice Address - Street 2:BOX 116
Practice Address - City:ALBION
Practice Address - State:PA
Practice Address - Zip Code:16401-1348
Practice Address - Country:US
Practice Address - Phone:814-756-4600
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS007420L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical