Provider Demographics
NPI:1164788568
Name:SCOTT HELLER, SHERRYL (PHD)
Entity Type:Individual
Prefix:
First Name:SHERRYL
Middle Name:
Last Name:SCOTT HELLER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:SHERRY
Other - Middle Name:
Other - Last Name:HELLER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:1440 CANAL ST
Mailing Address - Street 2:TB-52
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70112-2703
Mailing Address - Country:US
Mailing Address - Phone:504-988-5402
Mailing Address - Fax:504-988-4264
Practice Address - Street 1:1415 TULANE AVE
Practice Address - Street 2:HC-82
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112-2600
Practice Address - Country:US
Practice Address - Phone:504-988-5401
Practice Address - Fax:504-988-4264
Is Sole Proprietor?:No
Enumeration Date:2012-04-10
Last Update Date:2012-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA872103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist