Provider Demographics
NPI:1710084306
Name:HELMUTH, JAMES LAMAR (PHD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:LAMAR
Last Name:HELMUTH
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3200 W MARKET ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:FAIRLAWN
Mailing Address - State:OH
Mailing Address - Zip Code:44333-3335
Mailing Address - Country:US
Mailing Address - Phone:330-873-9866
Mailing Address - Fax:330-873-1428
Practice Address - Street 1:3200 W MARKET ST
Practice Address - Street 2:SUITE 101
Practice Address - City:FAIRLAWN
Practice Address - State:OH
Practice Address - Zip Code:44333-3335
Practice Address - Country:US
Practice Address - Phone:330-873-9866
Practice Address - Fax:330-873-1428
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2875103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0412477Medicaid
OH0412477Medicaid
OHHECP02041 9267201Medicare ID - Type Unspecified