Active NPI
Jennifer Jean Herman, LICSW
- Clinical Social Worker
- St Paul, MN
National Provider Identifier
1750496451
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 13644
- Practice address
- 2550 University Ave W
Suite 4355
St Paul, MN 55114 - Phone
- (651) 647-1900
- Fax
- (651) 647-1861
- NPI assigned
- Aug 20, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 13644 | MN | Primary |
| Marriage & Family Therapist | 106H00000X | 1087 | MN |
Addresses
Primary practice location
2550 University Ave W
Suite 4355
St Paul, MN 55114
Mailing address
2550 University Ave W
# 4355
St Paul, MN 55114
Phone (651) 647-1900
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 120113100 | Medicaid | MN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1087 | MN | MD | Acupuncturist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Midwest Center for Personal & Family Development PA | Past | Accepting new patients | |
| Pathway Virtu-Health | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Saint Paul, MN
- NPI 1285730903
-
- Family Nurse Practitioner
- Shoreview, MN
- NPI 1073134284
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156032000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1489968000000",
"number": "1750496451",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2550 UNIVERSITY AVE W",
"address_2": "# 4355",
"city": "ST PAUL",
"state": "MN",
"postal_code": "55114",
"telephone_number": "651-647-1900",
"fax_number": "651-647-1861"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2550 UNIVERSITY AVE W",
"address_2": "SUITE 4355",
"city": "ST PAUL",
"state": "MN",
"postal_code": "55114",
"telephone_number": "651-647-1900",
"fax_number": "651-647-1861"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERMAN",
"first_name": "JENNIFER",
"middle_name": "JEAN",
"name_prefix": "Ms.",
"credential": "LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-20",
"last_updated": "2017-03-20",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MN",
"license": "13644",
"primary": true
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "MN",
"license": "1087",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "120113100",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in St Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.