Provider Demographics
NPI:1043454952
Name:HELMUELLER, IXIA VELEZ (LICSW)
Entity Type:Individual
Prefix:
First Name:IXIA
Middle Name:VELEZ
Last Name:HELMUELLER
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 OLD 6TH ST W
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55102-1026
Mailing Address - Country:US
Mailing Address - Phone:651-222-3001
Mailing Address - Fax:
Practice Address - Street 1:215 OLD 6TH ST W
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55102-1026
Practice Address - Country:US
Practice Address - Phone:651-222-3001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-22
Last Update Date:2009-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN176031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN17603OtherST OF MN