Provider Demographics
NPI:1598331993
Name:PIMENTAL, HEIDI LK MUKAI (LMHC)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:LK MUKAI
Last Name:PIMENTAL
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 1:45-503 LIKELIKE HWY
Mailing Address - Street 2:
Mailing Address - City:KANEOHE
Mailing Address - State:HI
Mailing Address - Zip Code:96744-2946
Mailing Address - Country:US
Mailing Address - Phone:808-688-8668
Mailing Address - Fax:
Practice Address - Street 1:45-503 LIKELIKE HWY
Practice Address - Street 2:
Practice Address - City:KANEOHE
Practice Address - State:HI
Practice Address - Zip Code:96744-2946
Practice Address - Country:US
Practice Address - Phone:808-688-8668
Practice Address - Fax:808-490-0944
Is Sole Proprietor?:No
Enumeration Date:2021-05-27
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMHC-771101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIMHC-771OtherSTATE LICENSE
HI002318Medicaid