Healthcare Provider Details

I. General information

NPI: 1720982291
Provider Name (Legal Business Name): BROOKE SUN MIN LEE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

98-030 HEKAHA ST STE 24
AIEA HI
96701-4911
US

IV. Provider business mailing address

98-1731 KAAHUMANU ST # 33C
AIEA HI
96701-1833
US

V. Phone/Fax

Practice location:
  • Phone: 808-724-6658
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMHCP-32-0
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: