Provider Demographics
NPI:1225166929
Name:HELLDOERFER, DEBBIE (LSW, LICDC-CS)
Entity Type:Individual
Prefix:
First Name:DEBBIE
Middle Name:
Last Name:HELLDOERFER
Suffix:
Gender:F
Credentials:LSW, LICDC-CS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 PARSONS AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-5331
Mailing Address - Country:US
Mailing Address - Phone:614-645-6246
Mailing Address - Fax:614-645-1482
Practice Address - Street 1:240 PARSONS AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-5331
Practice Address - Country:US
Practice Address - Phone:614-645-6246
Practice Address - Fax:614-645-1482
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2016-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH954467101YA0400X
OHS-0006172104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHS-0006172OtherLSW
OH954467OtherLICDC