Provider Demographics
NPI:1134602915
Name:HELLENKAMP, COLETTE CHRISTINE (MA, BSW)
Entity type:Individual
Prefix:
First Name:COLETTE
Middle Name:CHRISTINE
Last Name:HELLENKAMP
Suffix:
Gender:F
Credentials:MA, BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2118 N ALDER ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98406-6626
Mailing Address - Country:US
Mailing Address - Phone:253-353-3350
Mailing Address - Fax:
Practice Address - Street 1:5915 ORCHARD ST W
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98467-3824
Practice Address - Country:US
Practice Address - Phone:253-414-7461
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-08
Last Update Date:2018-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACG60421347101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health