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Provider Information for 1710084306


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Dr. JAMES LAMAR HELMUTH Ph.D.


Sex: Male

NPI: 1710084306
Last Updated: 2007-07-08
Certification Date:

Details

NameValue
NPI1710084306
Enumeration Date2006-09-17
NPI TypeNPI-1 Individual
Sole ProprietorYES
StatusActive
Mailing Address 3200 W MARKET ST
SUITE 101
FAIRLAWN, OH 44333-3335
United States

Phone: 330-873-9866 | Fax:330-873-1428
 
Primary Practice Address 3200 W MARKET ST
SUITE 101
FAIRLAWN, OH 44333-3335
United States

Phone: 330-873-9866 | Fax:330-873-1428
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
MEDICAIDOH0412477
Other (non-Medicare)OH341530493Federal Tax Identificatio
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 103T00000X - Psychologist OH2875