Provider Demographics
NPI:1366054876
Name:HEBERT, CHRISTIE LEE (MS, LPC)
Entity type:Individual
Prefix:
First Name:CHRISTIE
Middle Name:LEE
Last Name:HEBERT
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9685 E PALERMO AVE
Mailing Address - Street 2:
Mailing Address - City:GOLD CANYON
Mailing Address - State:AZ
Mailing Address - Zip Code:85118-7019
Mailing Address - Country:US
Mailing Address - Phone:307-247-5359
Mailing Address - Fax:
Practice Address - Street 1:6589 S KINGS RANCH RD STE M
Practice Address - Street 2:
Practice Address - City:GOLD CANYON
Practice Address - State:AZ
Practice Address - Zip Code:85118-2933
Practice Address - Country:US
Practice Address - Phone:480-371-5883
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-18
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-20937101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health