Provider Demographics
NPI:1134295298
Name:HELLER, MARA LEE (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:MARA
Middle Name:LEE
Last Name:HELLER
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:MISS
Other - First Name:MARA
Other - Middle Name:LEE
Other - Last Name:BENINATO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:23 HORSESHOE DR
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01501-1211
Mailing Address - Country:US
Mailing Address - Phone:617-543-9180
Mailing Address - Fax:
Practice Address - Street 1:88 LINCOLN ST
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-6354
Practice Address - Country:US
Practice Address - Phone:508-620-0010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5041101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health