Provider Demographics
NPI:1336396282
Name:SIMON-HELDT, SHERRY (MS)
Entity Type:Individual
Prefix:MRS
First Name:SHERRY
Middle Name:
Last Name:SIMON-HELDT
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:SHERRY
Other - Middle Name:
Other - Last Name:SIMON-HELDT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS
Mailing Address - Street 1:4510 N TIERRA ALTA DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85749-9496
Mailing Address - Country:US
Mailing Address - Phone:520-990-4257
Mailing Address - Fax:
Practice Address - Street 1:4510 N TIERRA ALTA DR
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85749-9496
Practice Address - Country:US
Practice Address - Phone:520-990-4257
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-22
Last Update Date:2008-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ10307101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)