Provider Demographics
NPI:1568046803
Name:FENTRESS, HELEN ELIZABETH (LMFTA)
Entity Type:Individual
Prefix:
First Name:HELEN
Middle Name:ELIZABETH
Last Name:FENTRESS
Suffix:
Gender:F
Credentials:LMFTA
Other - Prefix:
Other - First Name:LIBBY
Other - Middle Name:
Other - Last Name:FENTRESS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMFTA
Mailing Address - Street 1:7745 BALLANTYNE COMMONS PKWY STE 102
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-2442
Mailing Address - Country:US
Mailing Address - Phone:704-995-0342
Mailing Address - Fax:
Practice Address - Street 1:7745 BALLANTYNE COMMONS PKWY STE 102
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-2442
Practice Address - Country:US
Practice Address - Phone:704-995-0342
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-12
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12270A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty