Individual
JASON HERR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMHC, CP
Contact information
Practice address
1409 E 84TH PL, MERRILLVILLE, IN 46410-6451
(219) 794-2000
(219) 794-2010
Mailing address
8400 LOUISIANA ST, MERRILLVILLE, IN 46410-6385
(219) 757-1928
(219) 757-1950
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
39002060A
IN
103TC0700X
Clinical Psychologist
071008452
IL
103TC0700X
Clinical Psychologist
Primary
20042635A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000616380
ANTHEM
IN
Enumeration date
09/03/2008
Last updated
11/28/2012
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