Provider Demographics
NPI:1699823708
Name:HELLER, SHERI RAE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:SHERI
Middle Name:RAE
Last Name:HELLER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 W 38TH ST
Mailing Address - Street 2:#1410
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10018-2999
Mailing Address - Country:US
Mailing Address - Phone:212-594-9801
Mailing Address - Fax:718-499-0575
Practice Address - Street 1:330 W 38TH ST
Practice Address - Street 2:#1410
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10018-2999
Practice Address - Country:US
Practice Address - Phone:212-594-9801
Practice Address - Fax:718-499-0575
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0387141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY115165OtherVALUE OPTIONS
NY7404006OtherGHI-BMP
NYP2783337OtherOXFORD
NYN2M981Medicare PIN