Provider Demographics
NPI:1801115571
Name:HELT, DALE PATRICK (MA)
Entity type:Individual
Prefix:MR
First Name:DALE
Middle Name:PATRICK
Last Name:HELT
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 120TH ST S
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98444-3703
Mailing Address - Country:US
Mailing Address - Phone:253-590-6016
Mailing Address - Fax:
Practice Address - Street 1:4113 BRIDGEPORT WAY W STE C2
Practice Address - Street 2:
Practice Address - City:UNIVERSITY PLACE
Practice Address - State:WA
Practice Address - Zip Code:98466-4325
Practice Address - Country:US
Practice Address - Phone:253-590-6016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-20
Last Update Date:2010-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC 00049432101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health