MEDICARE: JAMIE LYNN HERRING MA, LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	35001961A	IN

General Provider Information

NPI Number	:	1508996471
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMIE LYNN HERRING MA, LMFT

Provider Business Mailing Address
First Line	:	2420 N COLISEUM BLVD STE 103
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46805-3139
Country	:	US
Telephone Number	:	260-305-0734
Fax Number	:

Provider Business Practice Location Address
First Line	:	2420 N COLISEUM BLVD STE 103
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46805-3139
Country	:	US
Telephone Number	:	260-305-0734
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/07/2007
Last Update Date	:	09/22/2025

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