Provider Demographics
NPI:1952102568
Name:HERMAN, GLORY MAE (CMHC)
Entity type:Individual
Prefix:
First Name:GLORY
Middle Name:MAE
Last Name:HERMAN
Suffix:
Gender:
Credentials:CMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:941 S 1500 E
Mailing Address - Street 2:
Mailing Address - City:SPANISH FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84660-8479
Mailing Address - Country:US
Mailing Address - Phone:801-645-3903
Mailing Address - Fax:
Practice Address - Street 1:5314 RIVER RUN DR
Practice Address - Street 2:
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84604-5691
Practice Address - Country:US
Practice Address - Phone:801-787-9855
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-20
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8062883-6004101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health