Provider Demographics
NPI:1427464924
Name:HERMES, SHEILA (MED, LPCC, LADC)
Entity type:Individual
Prefix:
First Name:SHEILA
Middle Name:
Last Name:HERMES
Suffix:
Gender:F
Credentials:MED, LPCC, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11549 LAKE LN
Mailing Address - Street 2:SUITE 2
Mailing Address - City:CHISAGO CITY
Mailing Address - State:MN
Mailing Address - Zip Code:55013-9830
Mailing Address - Country:US
Mailing Address - Phone:651-257-2733
Mailing Address - Fax:651-257-2783
Practice Address - Street 1:11549 LAKE LN
Practice Address - Street 2:SUITE 2
Practice Address - City:CHISAGO CITY
Practice Address - State:MN
Practice Address - Zip Code:55013-9830
Practice Address - Country:US
Practice Address - Phone:651-257-2733
Practice Address - Fax:651-257-2783
Is Sole Proprietor?:No
Enumeration Date:2014-07-03
Last Update Date:2014-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN300524101YA0400X
MNCC00789101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)