| Doctor Name: | KERRY N. HERNDON |
| NPI Number: | 1023456571 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW, LAC |
| License Number: | 2723 |
| Business Practice Address: | 800 Kensington Ave Suite Ll2 Missoula, MT - 598015674 |
| Business Phone Number: | 4065525237 |
| Business Fax Number: | |
| Mailing Address: | 800 Kensington Ave Ste Ll2, MISSOULA |
| State: | MT |
| Postal Code: | 598015670 |
| Phone Number: | 4065525237 |
| Fax Number: | |
| NPI Enumeration Date: | 06/06/2013 |
| NPI Last Update Date: | 09/09/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 2723 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MT |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |