Provider Demographics
NPI:1912638370
Name:ALEXIS HERMAN, PSYD L.L.C.
Entity Type:Organization
Organization Name:ALEXIS HERMAN, PSYD L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:
Authorized Official - Last Name:DOWNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-296-9792
Mailing Address - Street 1:1600 WILSON BLVD STE 702
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22209-2505
Mailing Address - Country:US
Mailing Address - Phone:202-656-1008
Mailing Address - Fax:
Practice Address - Street 1:1600 WILSON BLVD STE 702
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22209-2505
Practice Address - Country:US
Practice Address - Phone:202-656-1008
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-17
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty