Doctor Name: | DR. WILLIAM RANDOLPH HERMAN |
NPI Number: | 1013392182 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCSW |
License Number: | LICSW 9577 |
Business Practice Address: | 108 Esther St New Smyrna Beach, FL - 321692516 |
Business Phone Number: | 3864024357 |
Business Fax Number: | |
Mailing Address: | 108 Esther St, NEW SMYRNA BEACH |
State: | FL |
Postal Code: | 321692516 |
Phone Number: | 3864024357 |
Fax Number: | |
NPI Enumeration Date: | 07/29/2015 |
NPI Last Update Date: | 07/29/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | LICSW 9577 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MN |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |