Provider Demographics
NPI:1508996471
Name:HERRING, JAMIE LYNN (MA, LMFT)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:LYNN
Last Name:HERRING
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2025 EDISON RD STE A
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46637-5600
Mailing Address - Country:US
Mailing Address - Phone:574-386-7323
Mailing Address - Fax:574-287-1667
Practice Address - Street 1:2025 EDISON RD STE A
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46637-5600
Practice Address - Country:US
Practice Address - Phone:574-386-7323
Practice Address - Fax:574-287-1667
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN35001961A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist