Provider Demographics
NPI:1487426433
Name:HERMANN, MINDY ANN I (MSW LSW)
Entity type:Individual
Prefix:MS
First Name:MINDY
Middle Name:ANN
Last Name:HERMANN
Suffix:I
Gender:F
Credentials:MSW LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2837 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:BERWYN
Mailing Address - State:IL
Mailing Address - Zip Code:60402-5953
Mailing Address - Country:US
Mailing Address - Phone:773-951-0217
Mailing Address - Fax:
Practice Address - Street 1:411 MADISON ST
Practice Address - Street 2:
Practice Address - City:MAYWOOD
Practice Address - State:IL
Practice Address - Zip Code:60153-2136
Practice Address - Country:US
Practice Address - Phone:773-450-3500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-24
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150105524104100000X
IL150.105524104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker