Cory David Hermann, LPCC (MN) LPC (WI)

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

CC02156 Issued in MN

Practice address

1109 Central Ave
Red Wing, MN 55066-3138

Phone

(507) 513-5552

NPI assigned

Nov 5, 2021

Sex

Male

Sole proprietor

Yes

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": "1636070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636070400000",
    "number": "1336804145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 544",
            "city": "RED WING",
            "state": "MN",
            "postal_code": "550660544",
            "telephone_number": "507-513-5552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1109 CENTRAL AVE",
            "city": "RED WING",
            "state": "MN",
            "postal_code": "550663138",
            "telephone_number": "507-513-5552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERMANN",
        "first_name": "CORY",
        "middle_name": "DAVID",
        "credential": "LPCC (MN) LPC (WI)",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-11-05",
        "last_updated": "2021-11-05",
        "certification_date": "2021-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "CC02156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Red Wing, MN
• Providers in Red Wing, MN by specialty
• Professional Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2021; 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.