Kelly Herrmann

Primary specialty

PsychologistTaxonomy code 103T00000X

License

3062616 Issued in NY

Practice address

1400 Old Country Rd Ste C103N
Westbury, NY 11590-5156

Phone

(631) 747-8379

NPI assigned

Aug 11, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1660176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748822400000",
    "number": "1124756705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 OLD COUNTRY RD STE C103N",
            "city": "WESTBURY",
            "state": "NY",
            "postal_code": "115905156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 OLD COUNTRY RD STE C103N",
            "city": "WESTBURY",
            "state": "NY",
            "postal_code": "115905156",
            "telephone_number": "631-747-8379"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "750 Hicksville Rd",
            "address_purpose": "LOCATION",
            "city": "Seaford",
            "state": "NY",
            "postal_code": "117831328",
            "country_code": "US",
            "telephone_number": "516-520-6021",
            "fax_number": "516-796-6341",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERRMANN",
        "first_name": "KELLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-11",
        "last_updated": "2025-06-02",
        "certification_date": "2025-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "3062616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Westbury, NY
• Providers in Westbury, NY by specialty
• Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2025; 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.