Basic Information
Provider Information
NPI: 1750626792
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HERMES
FirstName: ADRIENNE
MiddleName:  
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Credential: LPC
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Mailing Information
Address1: 1000 JEFFERSON ST.
Address2: SUITE 2C
City: LYNCHBURG
State: VA
PostalCode: 24504
CountryCode: US
TelephoneNumber: 6173790496
FaxNumber: 6178070958
Practice Location
Address1: 1518 WALNUT ST.
Address2: STE. 804
City: PHILADELPHIA
State: PA
PostalCode: 19102
CountryCode: US
TelephoneNumber: 2153999764
FaxNumber: 7168311818
Other Information
ProviderEnumerationDate: 12/03/2012
LastUpdateDate: 03/18/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
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AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YA0400X  N Behavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
101YA0400XPC007037PAY Behavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)

No ID Information.


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