MEDICARE: MS. TEARANY HELMS CDCA

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	CDCA.162301	OH

General Provider Information

NPI Number	:	1093250458
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. TEARANY HELMS CDCA

Provider Business Mailing Address
First Line	:	311 E MARKET ST FL 3
Second Line	:
City	:	LIMA
State	:	OH
Zip	:	45801-4535
Country	:	US
Telephone Number	:	419-222-4474
Fax Number	:	419-222-7044

Provider Business Practice Location Address
First Line	:	311 E MARKET ST FL 3
Second Line	:
City	:	LIMA
State	:	OH
Zip	:	45801-4535
Country	:	US
Telephone Number	:	419-222-4474
Fax Number	:	419-222-7044

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

Provider Enumeration Date	:	12/21/2016
Last Update Date	:	12/21/2016

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