Mark a. Herrmann, PH.D., P.C.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

57000132A Issued in IN

Legal business name

MARK A. HERRMANN, PH.D., P.C.

Practice address

3705 N Bittersweet Dr
Bloomington, IN 47408-9656

Phone

(812) 331-0946

NPI assigned

Dec 11, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Mark A. Herrmann, PH.D.

Title

President

Phone

(812) 331-0946

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1228953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228953600000",
    "number": "1083859557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3705 N BITTERSWEET DR",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474089656",
            "telephone_number": "812-331-0946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3705 N BITTERSWEET DR",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474089656",
            "telephone_number": "812-331-0946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK A. HERRMANN, PH.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-11",
        "last_updated": "2008-12-11",
        "status": "A",
        "authorized_official_last_name": "HERRMANN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "812-331-0946",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "57000132A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200043730B",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Bloomington, IN
• Providers in Bloomington, IN by specialty
• Clinical Psychologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.