Provider Demographics
NPI:1992041040
Name:FONYA LORD HELM, PH.D., P.C,
Entity Type:Organization
Organization Name:FONYA LORD HELM, PH.D., P.C,
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:FONYA
Authorized Official - Middle Name:L
Authorized Official - Last Name:HELM
Authorized Official - Suffix:
Authorized Official - Credentials:PHD,
Authorized Official - Phone:757-282-3525
Mailing Address - Street 1:504 SUSAN CONSTANT DR
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23451-2150
Mailing Address - Country:US
Mailing Address - Phone:757-282-3525
Mailing Address - Fax:757-361-1350
Practice Address - Street 1:504 SUSAN CONSTANT DR
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23451-2150
Practice Address - Country:US
Practice Address - Phone:757-282-3525
Practice Address - Fax:757-361-1350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-18
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810002446103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty