Provider Demographics
NPI:1063981090
Name:HEMERSBACH, FRANK JOSEPH (MA, LMFT, LSW)
Entity type:Individual
Prefix:
First Name:FRANK
Middle Name:JOSEPH
Last Name:HEMERSBACH
Suffix:
Gender:M
Credentials:MA, LMFT, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7623 SOUTH SR 75
Mailing Address - Street 2:
Mailing Address - City:CUTLER
Mailing Address - State:IN
Mailing Address - Zip Code:46920
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:15 EXECUTIVE DR STE 3
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47905-4868
Practice Address - Country:US
Practice Address - Phone:765-427-3310
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-20
Last Update Date:2018-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN33002808A104100000X
IN35000355A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No104100000XBehavioral Health & Social Service ProvidersSocial Worker