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NPI Code Detail

MEDICARE: MRS. SANDRA KAY HELLER L.C.S.W.

MEDICARE: MRS. SANDRA KAY HELLER L.C.S.W.
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
11041C0700XClinical Social Worker002406CT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1140002406-CT-01OTHERCTANTHEM PROVIDER NUMBER

General Provider Information

NPI Number : 1255340071
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SANDRA KAY HELLER L.C.S.W.
Provider Business Mailing Address
First Line : 8 FORGE RD
Second Line :
City : WILTON
State : CT
Zip : 06897-3708
Country : US
Telephone Number : 203-563-9220
Fax Number :
Provider Business Practice Location Address
First Line : 47 LONG LOTS RD
Second Line :
City : WESTPORT
State : CT
Zip : 06880-3828
Country : US
Telephone Number : 203-221-8823
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/08/2006
Last Update Date : 07/08/2007

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