Provider Demographics
NPI:1851895908
Name:HELFFENSTEIN, DIANA MARIE (MA)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:MARIE
Last Name:HELFFENSTEIN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18425 SUNBURST DR
Mailing Address - Street 2:
Mailing Address - City:MONUMENT
Mailing Address - State:CO
Mailing Address - Zip Code:80132-8255
Mailing Address - Country:US
Mailing Address - Phone:719-337-2408
Mailing Address - Fax:719-488-8755
Practice Address - Street 1:6140 TUTT BLVD STE 120
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80923-3574
Practice Address - Country:US
Practice Address - Phone:719-266-0438
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-22
Last Update Date:2018-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO175101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NONEOtherNONE