Provider Demographics
NPI:1447364732
Name:HELLER, JEFFREY A (PSYD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:A
Last Name:HELLER
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7555 ALGONQUIN DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45243-3519
Mailing Address - Country:US
Mailing Address - Phone:513-272-2733
Mailing Address - Fax:513-272-2733
Practice Address - Street 1:260 NORTHLAND BLVD STE 318
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45246-4921
Practice Address - Country:US
Practice Address - Phone:513-272-2733
Practice Address - Fax:513-272-2733
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4687103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH708206000OtherMAGELLAN BEHAVIORAL HEALT
OH2389893Medicaid
OH000000002596OtherANTHEM/BCBS