Provider Demographics
NPI:1891112694
Name:WYNN HELMS
Entity Type:Organization
Organization Name:WYNN HELMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST/PSYCHOTHERAPY
Authorized Official - Prefix:MS
Authorized Official - First Name:WYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:HELMS
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:818-301-0203
Mailing Address - Street 1:14156 MAGNOLIA BLVD
Mailing Address - Street 2:#105
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91423-1181
Mailing Address - Country:US
Mailing Address - Phone:818-301-0203
Mailing Address - Fax:818-301-0205
Practice Address - Street 1:14156 MAGNOLIA BLVD
Practice Address - Street 2:#105
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91423-1181
Practice Address - Country:US
Practice Address - Phone:818-301-0203
Practice Address - Fax:818-301-0205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-19
Last Update Date:2015-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35111251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health