Provider Demographics
NPI:1700968112
Name:HELLER, HOPE N (PHD)
Entity Type:Individual
Prefix:
First Name:HOPE
Middle Name:N
Last Name:HELLER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10411 CLAYTON RD
Mailing Address - Street 2:STE 305
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63131-2913
Mailing Address - Country:US
Mailing Address - Phone:314-567-7500
Mailing Address - Fax:314-567-8512
Practice Address - Street 1:10411 CLAYTON RD
Practice Address - Street 2:STE 305
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63131-2913
Practice Address - Country:US
Practice Address - Phone:314-567-7500
Practice Address - Fax:314-567-8512
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2016-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO000144OtherMISSOURI STATE LICENSE NO
MO000144OtherMISSOURI STATE LICENSE NO