Basic Information
Provider Information
NPI: 1932798683
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HELTON
FirstName: CHRISTOPHER
MiddleName: L
NamePrefix: DR.
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 273 HIGHWAY 11 E
Address2:  
City: BULLS GAP
State: TN
PostalCode: 377113433
CountryCode: US
TelephoneNumber: 4233934146
FaxNumber:  
Practice Location
Address1: 273 HIGHWAY 11 E
Address2:  
City: BULLS GAP
State: TN
PostalCode: 377113433
CountryCode: US
TelephoneNumber: 4233934146
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/15/2021
LastUpdateDate: 01/15/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/15/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YP2500X5210TNY Behavioral Health & Social Service ProvidersCounselorProfessional

No ID Information.


Home