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General NPI Number Information
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NPI Number | 1245429489
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Entity Type | Individual
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Provider Name | JOHN RICHARD HERINGTON MSW
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Gender | Male
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Dates
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Enumeration Date | 10/23/2007
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Last Update Date | 10/23/2007
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Provider Practice Location Address
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Address Line | 2490 N WATER ST SUITE 1
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City | DECATUR
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State | IL
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Zip | 62526-4251
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Country | US
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Telephone | 217-233-1327
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Fax | 217-233-1328
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Provider Business Mailing Address
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Address Line | PO BOX 30
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City | WARRENSBURG
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State | IL
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Zip | 62573-0030
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Country | US
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Telephone | 217-233-1327
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Fax | 217-233-1328
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 149-1721
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License Number State | IL
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