Provider Demographics
NPI:1881393791
Name:PAEZ, KIMBERLY LEILANI (LMHC)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:LEILANI
Last Name:PAEZ
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:87-1972 PAKEKE ST APT E
Mailing Address - Street 2:
Mailing Address - City:WAIANAE
Mailing Address - State:HI
Mailing Address - Zip Code:96792-3493
Mailing Address - Country:US
Mailing Address - Phone:808-304-5509
Mailing Address - Fax:
Practice Address - Street 1:98-1238 KAAHUMANU ST STE 403
Practice Address - Street 2:
Practice Address - City:PEARL CITY
Practice Address - State:HI
Practice Address - Zip Code:96782-3292
Practice Address - Country:US
Practice Address - Phone:808-304-5509
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-28
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMHC-904101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health