Provider Demographics
NPI:1073557609
Name:APPLETON, HELEN PUGACZ (PHD)
Entity Type:Individual
Prefix:DR
First Name:HELEN
Middle Name:PUGACZ
Last Name:APPLETON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1629 S WIGGINS AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62704-3371
Mailing Address - Country:US
Mailing Address - Phone:217-793-3949
Mailing Address - Fax:217-793-3995
Practice Address - Street 1:SPRINGFIELD PSYCHOLOGICAL CENTER
Practice Address - Street 2:2325 WEST WHITE OAKS DRIVE, SUITE C
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62704-7420
Practice Address - Country:US
Practice Address - Phone:217-793-3949
Practice Address - Fax:217-793-3995
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071002838103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
933690Medicare ID - Type Unspecified