Provider Demographics
NPI:1851853758
Name:HELM, CHARLES A (LP)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:A
Last Name:HELM
Suffix:
Gender:M
Credentials:LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 PRESTON LANDING CIR
Mailing Address - Street 2:
Mailing Address - City:LITHIA SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30122-6846
Mailing Address - Country:US
Mailing Address - Phone:262-880-1432
Mailing Address - Fax:
Practice Address - Street 1:116 PRESTON LANDING CIR
Practice Address - Street 2:
Practice Address - City:LITHIA SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30122-6846
Practice Address - Country:US
Practice Address - Phone:262-880-1432
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-01
Last Update Date:2019-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY004184103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA83-4214464OtherPRIVATE