Provider Demographics
NPI:1033714910
Name:J HERSCHBERGER LLC
Entity Type:Organization
Organization Name:J HERSCHBERGER LLC
Other - Org Name:BLUE OAK THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LMFT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:K
Authorized Official - Last Name:HERSCHBERGER
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:317-695-5392
Mailing Address - Street 1:600 E CARMEL DR STE 131
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-3051
Mailing Address - Country:US
Mailing Address - Phone:317-695-5302
Mailing Address - Fax:
Practice Address - Street 1:600 E CARMEL DR STE 131
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-3051
Practice Address - Country:US
Practice Address - Phone:317-695-5302
Practice Address - Fax:317-669-9739
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-01
Last Update Date:2022-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty