| Doctor Name: | MICHAEL HEROLD |
| NPI Number: | 1669870093 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.A., PLPC |
| License Number: | 2014009582 |
| Business Practice Address: | 2608 Gravois Rd High Ridge, MO - 630492508 |
| Business Phone Number: | 3142528959 |
| Business Fax Number: | |
| Mailing Address: | 2608 Gravois Rd, HIGH RIDGE |
| State: | MO |
| Postal Code: | 630492508 |
| Phone Number: | 3142528959 |
| Fax Number: | |
| NPI Enumeration Date: | 12/17/2014 |
| NPI Last Update Date: | 12/17/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 2014009582 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |