Provider Demographics
NPI:1841977592
Name:HELTON, GWENDOLYN RENEE (LPCC-S, LCDC III)
Entity type:Individual
Prefix:
First Name:GWENDOLYN
Middle Name:RENEE
Last Name:HELTON
Suffix:
Gender:F
Credentials:LPCC-S, LCDC III
Other - Prefix:
Other - First Name:GWENDOLYN
Other - Middle Name:RENEE
Other - Last Name:POWERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:1112 CRESTWOOD HILLS DR
Mailing Address - Street 2:
Mailing Address - City:VANDALIA
Mailing Address - State:OH
Mailing Address - Zip Code:45377-2715
Mailing Address - Country:US
Mailing Address - Phone:937-478-8150
Mailing Address - Fax:
Practice Address - Street 1:1112 CRESTWOOD HILLS DR
Practice Address - Street 2:
Practice Address - City:VANDALIA
Practice Address - State:OH
Practice Address - Zip Code:45377-2715
Practice Address - Country:US
Practice Address - Phone:937-478-8150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-03
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLCDCIII.976137101YA0400X
OHE.0007780-SUPV101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)