MEDICARE: RACHELLE NICOLE HELLER LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	LC25972	ME
2	1041C0700X	Clinical Social Worker	0904020413	VA
3	1041C0700X	Clinical Social Worker	C014512	NC
4	1041C0700X	Clinical Social Worker	9981502	ID

General Provider Information

NPI Number	:	1013569359
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHELLE NICOLE HELLER LCSW

Provider Business Mailing Address
First Line	:	527 DAKOTA AVE
Second Line	:
City	:	NEW BERN
State	:	NC
Zip	:	28560-2400
Country	:	US
Telephone Number	:	570-899-5336
Fax Number	:

Provider Business Practice Location Address
First Line	:	527 DAKOTA AVE
Second Line	:
City	:	NEW BERN
State	:	NC
Zip	:	28560-2400
Country	:	US
Telephone Number	:	570-899-5336
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/16/2019
Last Update Date	:	06/19/2026

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