Provider Demographics
NPI:1194073247
Name:HEPLER, KRISTEN MICHELLE ELLIOTT (MA, LPC, BCN)
Entity type:Individual
Prefix:MISS
First Name:KRISTEN
Middle Name:MICHELLE ELLIOTT
Last Name:HEPLER
Suffix:
Gender:F
Credentials:MA, LPC, BCN
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:MICHELLE
Other - Last Name:ELLIOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5900 BALCONES DR # 21819
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-4257
Mailing Address - Country:US
Mailing Address - Phone:817-856-2783
Mailing Address - Fax:
Practice Address - Street 1:4744 KILPATRICK AVE
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76107-7228
Practice Address - Country:US
Practice Address - Phone:817-856-2783
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-21
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX68835101YP2500X, 101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health