Provider Demographics
NPI:1114125713
Name:MATHIS, CHRISTOPHER C (LPC)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:C
Last Name:MATHIS
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
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Mailing Address - Street 1:3210 WINTERHAWK DR
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79606-3359
Mailing Address - Country:US
Mailing Address - Phone:325-691-0258
Mailing Address - Fax:325-695-5200
Practice Address - Street 1:2401 S WILLIS ST STE 103
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79605-6248
Practice Address - Country:US
Practice Address - Phone:325-695-5200
Practice Address - Fax:325-695-5200
Is Sole Proprietor?:No
Enumeration Date:2007-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX60653101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional