Provider Demographics
NPI:1376163915
Name:ASPERILLA, JENNIFER P (LMHC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:P
Last Name:ASPERILLA
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 1:98-030 HEKAHA STREET, SUITE 24
Mailing Address - Street 2:
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-4911
Mailing Address - Country:US
Mailing Address - Phone:808-753-7483
Mailing Address - Fax:
Practice Address - Street 1:98-030 HEKAHA STREET, SUITE 24
Practice Address - Street 2:
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-4911
Practice Address - Country:US
Practice Address - Phone:808-753-7483
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-23
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMHC666101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health