Provider Demographics
NPI:1821278045
Name:VAN DAM, HELEN JOYCE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:HELEN
Middle Name:JOYCE
Last Name:VAN DAM
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 1:3401 CUTTING HORSE RD
Mailing Address - Street 2:
Mailing Address - City:NORCO
Mailing Address - State:CA
Mailing Address - Zip Code:92860-5108
Mailing Address - Country:US
Mailing Address - Phone:951-582-0382
Mailing Address - Fax:951-582-0382
Practice Address - Street 1:1538 HOWARD ACCESS RD STE B
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-2581
Practice Address - Country:US
Practice Address - Phone:909-635-8077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-05
Last Update Date:2013-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS101271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical