Provider Demographics
NPI:1609372002
Name:HELM, SHELLI L (PHD)
Entity Type:Individual
Prefix:MS
First Name:SHELLI
Middle Name:L
Last Name:HELM
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8200 HUMBOLDT AVE S STE 217
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55431-1432
Mailing Address - Country:US
Mailing Address - Phone:913-515-9339
Mailing Address - Fax:913-837-8270
Practice Address - Street 1:8200 HUMBOLDT AVE S STE 217
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55431
Practice Address - Country:US
Practice Address - Phone:913-515-9339
Practice Address - Fax:913-837-8270
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-04
Last Update Date:2018-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1110103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical