Provider Demographics
NPI:1366688566
Name:RICHARDS, HELENA GUTIERREZ (LCSW)
Entity Type:Individual
Prefix:
First Name:HELENA
Middle Name:GUTIERREZ
Last Name:RICHARDS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:807 CHILDRENS WAY
Mailing Address - Street 2:DIVISION OF PEDIATRIC HEMATOLOGY/ONCOLOGY
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32207-8426
Mailing Address - Country:US
Mailing Address - Phone:904-390-3786
Mailing Address - Fax:904-390-3790
Practice Address - Street 1:807 CHILDRENS WAY
Practice Address - Street 2:DIVISION OF PEDIATRIC HEMATOLOGY/ONCOLOGY
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-8426
Practice Address - Country:US
Practice Address - Phone:904-390-3786
Practice Address - Fax:904-390-3790
Is Sole Proprietor?:No
Enumeration Date:2008-12-18
Last Update Date:2008-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW50911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical