Provider Demographics
NPI:1508309907
Name:HELLER, KATRIEL (LPC)
Entity Type:Individual
Prefix:
First Name:KATRIEL
Middle Name:
Last Name:HELLER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 MAGNOLIA SQ
Mailing Address - Street 2:SUITE 11
Mailing Address - City:LEXINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:24450-3779
Mailing Address - Country:US
Mailing Address - Phone:540-319-4213
Mailing Address - Fax:
Practice Address - Street 1:35 MAGNOLIA SQ
Practice Address - Street 2:SUITE 11
Practice Address - City:LEXINGTON
Practice Address - State:VA
Practice Address - Zip Code:24450-3779
Practice Address - Country:US
Practice Address - Phone:540-319-4213
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-02
Last Update Date:2017-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701006764101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health