Healthcare Provider Details

I. General information

NPI: 1245193812
Provider Name (Legal Business Name): HELEN MARIKA HAIDEMENOS LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/09/2025
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 LORING DR
FRAMINGHAM MA
01702-8785
US

IV. Provider business mailing address

138 SAMUEL AVE
PAWTUCKET RI
02860-1624
US

V. Phone/Fax

Practice location:
  • Phone: 508-532-5100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberLMHC12297
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: