Healthcare Provider Details

I. General information

NPI: 1366996878
Provider Name (Legal Business Name): DAVID THANOS HELIOTIS LPCC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2016
Last Update Date: 02/12/2026
Certification Date: 02/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2915 MARTIN LUTHER KING JR WAY
BERKELEY CA
94703-2133
US

IV. Provider business mailing address

1918 BONITA AVE STE 200
BERKELEY CA
94704-1014
US

V. Phone/Fax

Practice location:
  • Phone: 510-761-8451
  • Fax:
Mailing address:
  • Phone: 908-208-1273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number12999
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: