Provider Demographics
NPI:1629889779
Name:HERBERT PSYCHIATRY, LLC
Entity type:Organization
Organization Name:HERBERT PSYCHIATRY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HERBERT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:571-303-9019
Mailing Address - Street 1:19420 GOLF VISTA PLZ STE 350
Mailing Address - Street 2:
Mailing Address - City:LANSDOWNE
Mailing Address - State:VA
Mailing Address - Zip Code:20176-8268
Mailing Address - Country:US
Mailing Address - Phone:571-303-9019
Mailing Address - Fax:
Practice Address - Street 1:19420 GOLF VISTA PLZ STE 350
Practice Address - Street 2:
Practice Address - City:LANSDOWNE
Practice Address - State:VA
Practice Address - Zip Code:20176-8268
Practice Address - Country:US
Practice Address - Phone:571-303-9019
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-17
Last Update Date:2025-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty