Provider Demographics
NPI:1699474726
Name:HELLER, MINDY (PSYD)
Entity type:Individual
Prefix:DR
First Name:MINDY
Middle Name:
Last Name:HELLER
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 1:118 MARIA DR
Mailing Address - Street 2:
Mailing Address - City:WOODCLIFF LAKE
Mailing Address - State:NJ
Mailing Address - Zip Code:07677-8303
Mailing Address - Country:US
Mailing Address - Phone:201-306-2984
Mailing Address - Fax:
Practice Address - Street 1:118 MARIA DR
Practice Address - Street 2:
Practice Address - City:WOODCLIFF LAKE
Practice Address - State:NJ
Practice Address - Zip Code:07677-8303
Practice Address - Country:US
Practice Address - Phone:201-306-2984
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-27
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ64974OtherCERTIFICATION