Provider Demographics
NPI:1487938155
Name:HOPE N. HELLER, PH.D., PROFESSIONAL SERVICES
Entity type:Organization
Organization Name:HOPE N. HELLER, PH.D., PROFESSIONAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:
Authorized Official - First Name:HOPE
Authorized Official - Middle Name:N
Authorized Official - Last Name:HELLER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:314-567-7500
Mailing Address - Street 1:11330 OLIVE BLVD
Mailing Address - Street 2:SUITE 225
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-7149
Mailing Address - Country:US
Mailing Address - Phone:314-567-7500
Mailing Address - Fax:314-567-8512
Practice Address - Street 1:11330 OLIVE BLVD
Practice Address - Street 2:SUITE 225
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-7149
Practice Address - Country:US
Practice Address - Phone:314-567-7500
Practice Address - Fax:314-567-8512
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-29
Last Update Date:2012-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0001441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
000077804Medicare UPIN