Healthcare Provider Details

I. General information

NPI: 1912170036
Provider Name (Legal Business Name): KRISTIN F HEPLER M.ED, LPC, NCC, LCAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2008
Last Update Date: 06/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10001 OLD CONCORD ROAD
CHARLOTTE NC
28213
US

IV. Provider business mailing address

PO BOX 568
NEWELL NC
28126-0568
US

V. Phone/Fax

Practice location:
  • Phone: 704-547-1483
  • Fax: 704-547-0052
Mailing address:
  • Phone: 704-547-1483
  • Fax: 704-547-0052

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number203665
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6666
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: