Provider Demographics
NPI:1346485216
Name:HELLER, LORA F (MS, MT-BC, LCAT)
Entity Type:Individual
Prefix:MS
First Name:LORA
Middle Name:F
Last Name:HELLER
Suffix:
Gender:F
Credentials:MS, MT-BC, LCAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:585 W END AVE
Mailing Address - Street 2:#12E
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-1715
Mailing Address - Country:US
Mailing Address - Phone:212-874-5978
Mailing Address - Fax:
Practice Address - Street 1:585 W END AVE
Practice Address - Street 2:#12E
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-1715
Practice Address - Country:US
Practice Address - Phone:212-874-5978
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-08
Last Update Date:2008-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000400101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health