Provider Demographics
NPI:1083831218
Name:HELM, FONYA (PHD)
Entity Type:Individual
Prefix:DR
First Name:FONYA
Middle Name:
Last Name:HELM
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 1:8000 RIVERSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:CABIN JOHN
Mailing Address - State:MD
Mailing Address - Zip Code:20818-1627
Mailing Address - Country:US
Mailing Address - Phone:301-229-9120
Mailing Address - Fax:310-229-7239
Practice Address - Street 1:8000 RIVERSIDE AVE
Practice Address - Street 2:
Practice Address - City:CABIN JOHN
Practice Address - State:MD
Practice Address - Zip Code:20818-1627
Practice Address - Country:US
Practice Address - Phone:301-229-9120
Practice Address - Fax:310-229-7239
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD1008103TC0700X
DC755103TC0700X
VA002446103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1GG93OtherBLUECROSSBLUESHIELD
MDHE616637Medicare ID - Type Unspecified