Provider Demographics
NPI:1821535758
Name:HELENEK, KATHERINE MARIE
Entity Type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:MARIE
Last Name:HELENEK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4595 CHANCELLOR ST NE
Mailing Address - Street 2:340
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33703-4369
Mailing Address - Country:US
Mailing Address - Phone:240-477-3886
Mailing Address - Fax:
Practice Address - Street 1:4595 CHANCELLOR ST NE
Practice Address - Street 2:340
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33703-4369
Practice Address - Country:US
Practice Address - Phone:240-477-3886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-30
Last Update Date:2017-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician