Provider Demographics
NPI:1154172443
Name:HERMAN, MAKAYLA (LMSW)
Entity type:Individual
Prefix:
First Name:MAKAYLA
Middle Name:
Last Name:HERMAN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 DIMENSION CT
Mailing Address - Street 2:
Mailing Address - City:INWOOD
Mailing Address - State:WV
Mailing Address - Zip Code:25428-3925
Mailing Address - Country:US
Mailing Address - Phone:240-500-7899
Mailing Address - Fax:
Practice Address - Street 1:1850 DUAL HWY # 200
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-6620
Practice Address - Country:US
Practice Address - Phone:301-790-0572
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-27
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD24736104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker