Individual provider Active NPI

Patricia Lynn Herman, PH.D.

  • Counseling Psychologist
  • Cincinnati, OH
National Provider Identifier
1376632711
Registry record updated Feb 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
5770 Issued in OH
Practice address
4100 Executive Park Drive
Suite 2
Cincinnati, OH 45241
Phone
(513) 769-5111
Fax
(513) 769-1333
NPI assigned
Oct 12, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 14, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X 5770 OH Primary
Psychologist 103T00000X

Addresses

Primary practice location

4100 Executive Park Drive
Suite 2
Cincinnati, OH 45241

Mailing address

4100 Executive Park Drive
Suite 2
Cincinnati, OH 45241
Phone (513) 769-5111

Other identifiers 2

IdentifierTypeStateIssuer
2288902MedicaidOH
89001085MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Jan 1, 2014 through Jan 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
5770OHMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Psychiatric Professional Services Counseling Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329177600000",
    "number": "1376632711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 EXECUTIVE PARK DRIVE",
            "address_2": "SUITE 2",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "45241",
            "telephone_number": "513-769-5111",
            "fax_number": "513-769-1333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 EXECUTIVE PARK DRIVE",
            "address_2": "SUITE 2",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "45241",
            "telephone_number": "513-769-5111",
            "fax_number": "513-769-1333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERMAN",
        "first_name": "PATRICIA",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2012-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "OH",
            "license": "5770",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2288902",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89001085",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.