Provider Demographics
NPI:1952040941
Name:HERRICK PSYCHOLOGICAL SERVICES PLLC
Entity Type:Organization
Organization Name:HERRICK PSYCHOLOGICAL SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHD
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTEN
Authorized Official - Middle Name:
Authorized Official - Last Name:HERRICK
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:701-877-1806
Mailing Address - Street 1:201 SLATE DR STE 4
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58503-6181
Mailing Address - Country:US
Mailing Address - Phone:701-877-1806
Mailing Address - Fax:701-222-0331
Practice Address - Street 1:201 SLATE DR STE 4
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58503-6181
Practice Address - Country:US
Practice Address - Phone:701-877-1806
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-31
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty