Provider Demographics
NPI:1447808480
Name:HELLER, ROBERT (LPC)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:HELLER
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1251 WYOMING AVE
Mailing Address - Street 2:
Mailing Address - City:EXETER
Mailing Address - State:PA
Mailing Address - Zip Code:18643-1434
Mailing Address - Country:US
Mailing Address - Phone:570-342-8434
Mailing Address - Fax:570-299-2521
Practice Address - Street 1:1251 WYOMING AVE
Practice Address - Street 2:
Practice Address - City:EXETER
Practice Address - State:PA
Practice Address - Zip Code:18643-1434
Practice Address - Country:US
Practice Address - Phone:570-307-9069
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-03
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC014885101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty