Provider Demographics
NPI:1518254093
Name:HELLER, NERISSA (LCSW)
Entity Type:Individual
Prefix:
First Name:NERISSA
Middle Name:
Last Name:HELLER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:709 NW EVERETT ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97209-3517
Mailing Address - Country:US
Mailing Address - Phone:503-226-4060
Mailing Address - Fax:503-445-4913
Practice Address - Street 1:232 NW 6TH AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97209-3609
Practice Address - Country:US
Practice Address - Phone:503-294-1681
Practice Address - Fax:503-241-7419
Is Sole Proprietor?:No
Enumeration Date:2011-07-05
Last Update Date:2011-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator