MEDICARE: PAULA J. HELLER LCSW, BCD

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	1041C0700X	Clinical Social Worker	RO26377-3	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225101066
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAULA J. HELLER LCSW, BCD

Provider Business Mailing Address
First Line	:	21 GLEN HILL LN
Second Line	:
City	:	TARRYTOWN
State	:	NY
Zip	:	10591-5055
Country	:	US
Telephone Number	:	914-332-1223
Fax Number	:	914-332-1224

Provider Business Practice Location Address
First Line	:	239 N BROADWAY
Second Line	:
City	:	SLEEPY HOLLOW
State	:	NY
Zip	:	10591-2674
Country	:	US
Telephone Number	:	914-582-7595
Fax Number	:	914-332-1224

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

Provider Enumeration Date	:	11/17/2006
Last Update Date	:	07/08/2007

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