Provider Demographics
NPI:1417006834
Name:HELLENKAMP, JOEL T (MSW)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:T
Last Name:HELLENKAMP
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1404 N CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98406-6424
Mailing Address - Country:US
Mailing Address - Phone:253-752-6658
Mailing Address - Fax:253-752-6819
Practice Address - Street 1:1404 N CEDAR ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98406-6424
Practice Address - Country:US
Practice Address - Phone:253-752-6658
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW000045211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA127195100000OtherPREMERA PROVIDER NUMBER
WAHE4555OtherREGENCE RIDER NUMBER
WA0007559170OtherAETNA'S PROVIDER NUMBER
WAHE4555OtherREGENCE RIDER NUMBER