Provider Demographics
NPI:1659647642
Name:HELMBOLDT, DEANNE (LMFT)
Entity Type:Individual
Prefix:
First Name:DEANNE
Middle Name:
Last Name:HELMBOLDT
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5704 W 16TH STREET LN
Mailing Address - Street 2:
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80634-2969
Mailing Address - Country:US
Mailing Address - Phone:970-353-8626
Mailing Address - Fax:
Practice Address - Street 1:1703 61ST AVE STE 103
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-7999
Practice Address - Country:US
Practice Address - Phone:970-302-5506
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-24
Last Update Date:2012-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO293106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist