Provider Demographics
NPI:1699392555
Name:HELMER, DUANE STANLEY (LADC #302714)
Entity Type:Individual
Prefix:
First Name:DUANE
Middle Name:STANLEY
Last Name:HELMER
Suffix:
Gender:M
Credentials:LADC #302714
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:FIRST CALL FOR HELP OF ITASCA COUNTY
Mailing Address - Street 2:1707 NW 4TH STREET SUITE B
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:55744
Mailing Address - Country:US
Mailing Address - Phone:218-326-8565
Mailing Address - Fax:218-326-4634
Practice Address - Street 1:FIRST CALL FOR HELP OF ITASCA COUNTY
Practice Address - Street 2:1707 NW 4TH STREET SUITE B
Practice Address - City:GRAND RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:55744
Practice Address - Country:US
Practice Address - Phone:218-326-8565
Practice Address - Fax:218-326-4634
Is Sole Proprietor?:No
Enumeration Date:2020-06-26
Last Update Date:2020-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLADC30214101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)