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General NPI Number Information
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NPI Number | 1104348465
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Entity Type | Individual
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Provider Name | THERESA HELGESON LCSW
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Gender | Female
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Dates
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Enumeration Date | 07/08/2017
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Last Update Date | 06/29/2025
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Provider Practice Location Address
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Address Line | E968 GILARDI LN
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City | GENOA
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State | WI
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Zip | 54632-6800
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Country | US
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Telephone | 608-386-5331
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Fax |
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Provider Business Mailing Address
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Address Line | E968 GILARDI LN
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City | GENOA
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State | WI
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Zip | 54632-6800
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Country | US
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Telephone | 608-668-2332
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 130453-121
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 108650
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License Number State | IA
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 8968
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License Number State | WI
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