Active NPI
Bruce J Herman, PH.D
- Psychologist
- Towson, MD
National Provider Identifier
1679788913
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 03408
- Practice address
- 312 W Chesapeake Ave
Towson, MD 21204-4405 - Phone
- (410) 499-6043
- NPI assigned
- May 11, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 03408 | MD | Primary |
Addresses
Primary practice location
312 W Chesapeake Ave
Towson, MD 21204-4405
Mailing address
409 Dunkirk Rd
Baltimore, MD 21212-1816
Phone (410) 499-6043
Other names 1
- Bruce Grant Jaschik-Herman
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jun 18, 2024 through Jun 18, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 03408 | MD | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178841600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715817600000",
"number": "1679788913",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "409 DUNKIRK RD",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212121816",
"telephone_number": "410-499-6043"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "312 W CHESAPEAKE AVE",
"city": "TOWSON",
"state": "MD",
"postal_code": "212044405",
"telephone_number": "410-499-6043"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERMAN",
"first_name": "BRUCE",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "PH.D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-11",
"last_updated": "2024-05-16",
"certification_date": "2024-01-19",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MD",
"license": "03408",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "BRUCE",
"last_name": "JASCHIK-HERMAN",
"middle_name": "GRANT",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Towson, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.