Provider Demographics
NPI:1275262990
Name:HELMINICK, JONATHAN J (LPC-IT, SAC-IT, NCC)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:J
Last Name:HELMINICK
Suffix:
Gender:M
Credentials:LPC-IT, SAC-IT, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 WOLF ST
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53717-1837
Mailing Address - Country:US
Mailing Address - Phone:608-315-4918
Mailing Address - Fax:
Practice Address - Street 1:201 WOLF ST
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53717-1837
Practice Address - Country:US
Practice Address - Phone:608-315-4918
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-08
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5041-226101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health