Provider Demographics
NPI:1467892331
Name:HIRSCHY, JENNA I (MS)
Entity Type:Individual
Prefix:
First Name:JENNA
Middle Name:I
Last Name:HIRSCHY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:JENNA
Other - Middle Name:I
Other - Last Name:WILDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:2621 E JEFFERSON ST
Mailing Address - Street 2:PO BOX 497
Mailing Address - City:WARSAW
Mailing Address - State:IN
Mailing Address - Zip Code:46580-3880
Mailing Address - Country:US
Mailing Address - Phone:574-267-7169
Mailing Address - Fax:574-269-4189
Practice Address - Street 1:101 E PARK DR
Practice Address - Street 2:
Practice Address - City:ALBION
Practice Address - State:IN
Practice Address - Zip Code:46701-1438
Practice Address - Country:US
Practice Address - Phone:260-636-6884
Practice Address - Fax:260-636-3392
Is Sole Proprietor?:No
Enumeration Date:2013-06-25
Last Update Date:2021-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39003889A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health