| Doctor Name: | KEVIN HERBERT |
| NPI Number: | 1154675494 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LPC |
| License Number: | 2011024362 |
| Business Practice Address: | 1194 Lake Saint Louis Blvd Ste 4 Lake Saint Louis, MO - 633671486 |
| Business Phone Number: | 6362195432 |
| Business Fax Number: | |
| Mailing Address: | 1527 Oakland Hills Dr, O FALLON |
| State: | MO |
| Postal Code: | 633665569 |
| Phone Number: | 6362195432 |
| Fax Number: | |
| NPI Enumeration Date: | 11/08/2012 |
| NPI Last Update Date: | 11/08/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 2011024362 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MO |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |