Provider Demographics
NPI:1720454275
Name:HERMAN, AUSTIN L (BA)
Entity Type:Individual
Prefix:
First Name:AUSTIN
Middle Name:L
Last Name:HERMAN
Suffix:
Gender:M
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5863 W ATLANTIC PL
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80227-2541
Mailing Address - Country:US
Mailing Address - Phone:719-650-8201
Mailing Address - Fax:
Practice Address - Street 1:5931 MIDDLEFIELD RD STE 102
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80123-2865
Practice Address - Country:US
Practice Address - Phone:303-564-9987
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-19
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor