Provider Demographics
NPI:1558507293
Name:SANTOMEN HELLBERG, LISA ANN (MA, LPC)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:ANN
Last Name:SANTOMEN HELLBERG
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:144 ROCHELLE AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19128-3810
Mailing Address - Country:US
Mailing Address - Phone:215-884-9770
Mailing Address - Fax:215-848-3850
Practice Address - Street 1:614 N EASTON RD
Practice Address - Street 2:
Practice Address - City:GLENSIDE
Practice Address - State:PA
Practice Address - Zip Code:19038-4301
Practice Address - Country:US
Practice Address - Phone:215-884-9770
Practice Address - Fax:215-848-3850
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-31
Last Update Date:2013-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
PAPC007045101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional