Provider Demographics
NPI:1124382171
Name:HELMS, LISA (MS QMHP CADCI)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:HELMS
Suffix:
Gender:F
Credentials:MS QMHP CADCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 705
Mailing Address - Street 2:
Mailing Address - City:CONDON
Mailing Address - State:OR
Mailing Address - Zip Code:97823-0705
Mailing Address - Country:US
Mailing Address - Phone:541-384-2666
Mailing Address - Fax:541-384-3121
Practice Address - Street 1:422 N MAIN
Practice Address - Street 2:
Practice Address - City:CONDON
Practice Address - State:OR
Practice Address - Zip Code:97823-7651
Practice Address - Country:US
Practice Address - Phone:541-384-2666
Practice Address - Fax:541-384-3121
Is Sole Proprietor?:No
Enumeration Date:2012-06-25
Last Update Date:2012-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR10-03-15OtherACCBO