Provider Demographics
NPI:1205851904
Name:REINHART, JAN WISHER (LMHC)
Entity Type:Individual
Prefix:MS
First Name:JAN
Middle Name:WISHER
Last Name:REINHART
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12196 BLACK HILLS DR
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46038-5486
Mailing Address - Country:US
Mailing Address - Phone:317-439-7450
Mailing Address - Fax:317-678-6044
Practice Address - Street 1:12196 BLACK HILLS DR
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46038-5486
Practice Address - Country:US
Practice Address - Phone:317-776-0600
Practice Address - Fax:317-678-6044
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2019-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39000935A101YM0800X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN372811OtherCUMMINS