Provider Demographics
NPI:1003779661
Name:HEFNER, CHRISTOPHER
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:HEFNER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3809 S CONGRESS AVE APT 116
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-8014
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:512-713-0080
Practice Address - Street 1:3809 S CONGRESS AVE APT 116
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-8014
Practice Address - Country:US
Practice Address - Phone:321-514-5301
Practice Address - Fax:512-713-0080
Is Sole Proprietor?:Yes
Enumeration Date:2025-12-09
Last Update Date:2025-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX99372101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health