Provider Demographics
NPI:1629067293
Name:HEFEL, CHRISTINE M (LPC)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:M
Last Name:HEFEL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23535 IH 10 W
Mailing Address - Street 2:SUITE 3002
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78257-1690
Mailing Address - Country:US
Mailing Address - Phone:210-698-8818
Mailing Address - Fax:210-698-8821
Practice Address - Street 1:23535 IH 10 W
Practice Address - Street 2:SUITE 3002
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78257-1668
Practice Address - Country:US
Practice Address - Phone:210-698-8818
Practice Address - Fax:210-698-8821
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-17
Last Update Date:2012-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15180101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX095914002Medicaid