Provider Demographics
NPI:1316091580
Name:HELMER, TRACY LYN (PSYD)
Entity type:Individual
Prefix:DR
First Name:TRACY
Middle Name:LYN
Last Name:HELMER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:242 BUTLER CT
Mailing Address - Street 2:
Mailing Address - City:DALEVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24083-3225
Mailing Address - Country:US
Mailing Address - Phone:540-992-2307
Mailing Address - Fax:
Practice Address - Street 1:3247 ELECTRIC RD
Practice Address - Street 2:SUITE 1-A
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-6448
Practice Address - Country:US
Practice Address - Phone:540-772-0690
Practice Address - Fax:540-772-0692
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810003535103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical