Healthcare Provider Details

I. General information

NPI: 1962783860
Provider Name (Legal Business Name): CHRISTINE S HELMER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/06/2011
Last Update Date: 09/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4120 BALDWIN RD
RUSHVILLE NY
14544-9738
US

IV. Provider business mailing address

8588 GREIG ST
SODUS POINT NY
14555-9712
US

V. Phone/Fax

Practice location:
  • Phone: 585-554-6492
  • Fax: 585-554-4219
Mailing address:
  • Phone: 585-704-9238
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number074128-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: