Provider Demographics
NPI:1437557592
Name:MAYER, BENJAMIN ARON
Entity Type:Individual
Prefix:MR
First Name:BENJAMIN
Middle Name:ARON
Last Name:MAYER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 BARENABA LN
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-4217
Mailing Address - Country:US
Mailing Address - Phone:248-259-2754
Mailing Address - Fax:
Practice Address - Street 1:121 BARENABA LN
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-4217
Practice Address - Country:US
Practice Address - Phone:248-259-2754
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-05
Last Update Date:2014-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIM600085071116101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor