Provider Demographics
NPI:1790190163
Name:HELLESO, ERIN (LISW)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:HELLESO
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:
Other - Last Name:MCNAMARA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:900 NE SILKWOOD ST
Mailing Address - Street 2:
Mailing Address - City:GRIMES
Mailing Address - State:IA
Mailing Address - Zip Code:50111-2080
Mailing Address - Country:US
Mailing Address - Phone:515-326-0432
Mailing Address - Fax:
Practice Address - Street 1:5619 NW 86TH ST STE 500
Practice Address - Street 2:
Practice Address - City:JOHNSTON
Practice Address - State:IA
Practice Address - Zip Code:50131-2955
Practice Address - Country:US
Practice Address - Phone:515-240-7285
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-24
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA1009991041C0700X
251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No251S00000XAgenciesCommunity/Behavioral Health