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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

KELLY ELIZABETH HERMER
NPI 1205616190
Counselor - Mental Health in Waterloo, IA

Active since September 29, 2023PECOS Enrolled
3251 W 9TH ST, WATERLOO, IA 50702(319) 234-2893 Get Directions Write a Review

NPPES record last updated: October 7, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Oct 7, 2026, Jul 31, 2024 (2 updates tracked since 2024).

About Kelly Elizabeth Hermer NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KELLY ELIZABETH HERMER (NPI 1205616190) is an individual mental health provider in Waterloo, Iowa, licensed in Massachusetts (LMHC10007194) and active in the NPI registry since September 2023. She is enrolled in Medicare PECOS, maintains a secondary practice location in Cambridge, and is a graduate of Other (2023).

NPPES Registry Identity

NPI1205616190
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameKELLY ELIZABETH HERMER
Location Address3251 W 9TH STWaterloo, IA 50702-5310
Mailing Address3251 W 9th StWaterloo, IA 50702-5310 · (319) 234-2893
Phone(319) 234-2893
Sole ProprietorNo
Medical School CMSOtherGraduated 2023
Enumeration DateSeptember 29, 2023
Last NPPES UpdateOctober 7, 20262 updates tracked since enumeration
NPPES CertifiedOctober 7, 2026
✔ NPI 1205616190 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in MA · LMHC10007194
3251 W 9TH ST, Waterloo, IA 50702
Open in Google Maps ↗

Other Names 1

Former Name (1)Kelly Elizabeth Decker

Secondary Practice Location 1

Location 1700 Massachusetts Ave Fl 3Cambridge, MA 02139-3345 · Phone (888) 500-2067 · Fax (617) 649-8520

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kelly Elizabeth Hermer is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID4981168333
PECOS Enrollment IDI20260716000431
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Kelly Hermer reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Black Hawk-Grundy Mental Health Center Inc.
0.1 mi
Mental Health (Including Community Mental Health Center)
3251 W 9TH ST
Waterloo, IA 50702
  • Reassigned Medicare billing, Iowa enrollment
  • 28 clinicians in this Medicare group
NPI 1316944598 (319) 234-2893

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. BROOKE HOLMES RN
Registered Nurse (Psychiatric/Mental Health)
3251 W 9TH ST
WATERLOO, IA 50702
Black Hawk County (319) 234-2893
DR. JAMES HOWARD HARDING PH.D
Psychologist
3251 W 9TH ST
WATERLOO, IA 50702
Black Hawk County (319) 234-2893
GABRIELLA L HAYWOOD LMSW
Social Worker
3251 W 9TH ST
WATERLOO, IA 50702
Black Hawk County (319) 234-2893
AUTUMN SCHRAGE I LISW
Social Worker (Clinical)
3251 W 9TH ST
WATERLOO, IA 50702
Black Hawk County (319) 234-2893
MR. NICHOLAS DONALD ROSAUER LMSW
Social Worker (Clinical)
3251 W 9TH ST
WATERLOO, IA 50702
Black Hawk County (319) 234-2893
MARY ELISE HIGH
Social Worker (Clinical)
3251 W 9TH ST
WATERLOO, IA 50702
Black Hawk County (319) 415-7981
KELSEY OSTENDORF
Social Worker (Clinical)
3251 W 9TH ST
WATERLOO, IA 50702
Black Hawk County (319) 234-2893
MS. SHELLY MARIE WHALEN LMSW
Social Worker (Clinical)
3251 W 9TH ST
WATERLOO, IA 50702
Black Hawk County (319) 269-6146

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kelly Hermer's NPI number?

The NPI number for Kelly Hermer is 1205616190. It was assigned to this individual provider in the NPPES registry on September 29, 2023. The provider is also known as Kelly Elizabeth Decker.

Where is Kelly Hermer located?

Kelly Hermer practices at 3251 W 9th St, Waterloo, IA 50702. The listed phone number is (319) 234-2893.

What is Kelly Hermer's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Kelly Hermer enrolled in Medicare?

Yes. Kelly Hermer is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Kelly Hermer's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kelly Hermer reassigns Medicare benefits to Black Hawk-Grundy Mental Health Center Inc. (Waterloo, IA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kelly Hermer's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Kelly Hermer was last updated on October 7, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.