Healthcare Provider Details

I. General information

NPI: 1750271078
Provider Name (Legal Business Name): HELEN ANDREA KHEALIE LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2025
Last Update Date: 08/18/2025
Certification Date: 08/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

514 W 211TH ST APT 2K
NEW YORK NY
10034-5908
US

IV. Provider business mailing address

514 W 211TH ST APT 2K
NEW YORK NY
10034-5908
US

V. Phone/Fax

Practice location:
  • Phone: 917-745-6485
  • Fax:
Mailing address:
  • Phone: 917-745-6485
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number44SL07308700
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number127995-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: