Provider Demographics
NPI:1417769712
Name:HELLMER, KENNETH L (DMIN)
Entity type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:L
Last Name:HELLMER
Suffix:
Gender:M
Credentials:DMIN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6188
Mailing Address - Street 2:
Mailing Address - City:CHINA VILLAGE
Mailing Address - State:ME
Mailing Address - Zip Code:04926-0188
Mailing Address - Country:US
Mailing Address - Phone:207-595-1415
Mailing Address - Fax:
Practice Address - Street 1:1 VA CENTER
Practice Address - Street 2:CHAPLAIN SERVICE (125)
Practice Address - City:AUGUSTA
Practice Address - State:ME
Practice Address - Zip Code:04330
Practice Address - Country:US
Practice Address - Phone:207-623-5735
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-23
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2742195101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral