Individual provider Active NPI

John K Hershberger, LMFT, LMHC

  • Marriage & Family Therapist
  • Elkhart, IN
National Provider Identifier
1790711539
Registry record updated Aug 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
35000508A Issued in IN
Practice address
2600 Oakland Ave
Elkhart, IN 46517-1533
Phone
(574) 533-1234
Fax
(574) 537-2652
NPI assigned
Jun 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 39000464A IN
Marriage & Family Therapist 106H00000X 35000508A IN Primary

Addresses

Primary practice location

2600 Oakland Ave
Elkhart, IN 46517-1533

Mailing address

330 Lakeview Dr
Goshen, IN 46528-9365
Phone (574) 533-1234

Other identifiers 1

IdentifierTypeStateIssuer
000000204891OtherINANTHEM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
39000464AINMDMental Health Counselor
35000508AINMDMarriage & Family Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188259200000",
    "number": "1790711539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 LAKEVIEW DR",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465289365",
            "telephone_number": "574-533-1234",
            "fax_number": "574-537-2652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 OAKLAND AVE",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465171533",
            "telephone_number": "574-533-1234",
            "fax_number": "574-537-2652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERSHBERGER",
        "first_name": "JOHN",
        "middle_name": "K",
        "credential": "LMFT, LMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2007-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39000464A",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IN",
            "license": "35000508A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000204891",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkhart, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.