Provider Demographics
NPI:1598869588
Name:JOHN HERINGTON, PC
Entity Type:Organization
Organization Name:JOHN HERINGTON, PC
Other - Org Name:JOHN HERINGTON LCSW
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:HERINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:217-233-1327
Mailing Address - Street 1:PO BOX 30
Mailing Address - Street 2:
Mailing Address - City:WARRENSBURG
Mailing Address - State:IL
Mailing Address - Zip Code:62573-0030
Mailing Address - Country:US
Mailing Address - Phone:217-233-1327
Mailing Address - Fax:217-233-1328
Practice Address - Street 1:2490 N WATER ST
Practice Address - Street 2:SUITE 1
Practice Address - City:DECATUR
Practice Address - State:IL
Practice Address - Zip Code:62526-4251
Practice Address - Country:US
Practice Address - Phone:217-233-1327
Practice Address - Fax:217-233-1328
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-11
Last Update Date:2007-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149-17211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
68226OtherCIGNA
5808521OtherBC/BS
272843OtherMAGALLAN ID
272843OtherMAGALLAN ID
IL208521Medicare UPIN