Basic Information
| Provider Information | |||||||||
| NPI: | 1447319769 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HOUSTON | ||||||||
| FirstName: | HELENE | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | M.S,R.N,C.S. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 175 DWIGHT RD | ||||||||
| Address2: | SUITE 303 | ||||||||
| City: | LONGMEADOW | ||||||||
| State: | MA | ||||||||
| PostalCode: | 011061761 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4135679993 | ||||||||
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| Practice Location | |||||||||
| Address1: | 175 DWIGHT RD | ||||||||
| Address2: | SUITE 303 | ||||||||
| City: | LONGMEADOW | ||||||||
| State: | MA | ||||||||
| PostalCode: | 011061761 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4135679993 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/06/2006 | ||||||||
| LastUpdateDate: | 10/12/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 364SP0808X | 98903PC | MA | Y | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | Psych/Mental Health |
ID Information
| ID | Type | State | Issuer | Description | PN0656 | 01 | MA | BLUE CROSS | OTHER | 1858548 | 05 | MA | MEDICAID | 32015 | 01 | MA | HEALTH NEW ENGLAND | OTHER | 098903 | 01 | MA | TUFTS | OTHER |