Healthcare Provider Details

I. General information

NPI: 1275952319
Provider Name (Legal Business Name): CHRISTOPHER HERNANDEZ LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2014
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

838 W DIDIER AVE
BELEN NM
87002-3160
US

IV. Provider business mailing address

4494 JON CUNNINGHAM BLVD APT 8108
EL PASO TX
79934-3824
US

V. Phone/Fax

Practice location:
  • Phone: 575-281-4260
  • Fax:
Mailing address:
  • Phone: 915-283-8157
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberM-10305
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberX-10386
License Number StateNM
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSWB-2022-0153
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: