Active NPI
Patricia Lynn Herman, PH.D.
- Counseling Psychologist
- Cincinnati, OH
National Provider Identifier
1376632711
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- 5770
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2288902 | Medicaid | OH | |
| 89001085 | Medicaid | KY |
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
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 5770 | OH | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.