Healthcare Provider Details

I. General information

NPI: 1124893086
Provider Name (Legal Business Name): HEIDI PIMENTAL COUNSELING CENTER LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2023
Last Update Date: 02/20/2024
Certification Date: 02/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45-503 LIKELIKE HWY
KANEOHE HI
96744-2946
US

IV. Provider business mailing address

45-503 LIKELIKE HWY
KANEOHE HI
96744-2946
US

V. Phone/Fax

Practice location:
  • Phone: 808-688-8668
  • Fax: 808-490-0944
Mailing address:
  • Phone: 808-688-8668
  • Fax: 808-490-0944

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: HEIDI PIMENTAL
Title or Position: OWNER
Credential: LMHC
Phone: 808-688-8668