Provider Demographics
NPI:1851772800
Name:BATTISTINI, HIILEI KELLY (MA)
Entity Type:Individual
Prefix:
First Name:HIILEI
Middle Name:KELLY
Last Name:BATTISTINI
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:HIILEI
Other - Middle Name:KELLY
Other - Last Name:KAAIHILI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:1000 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-7667
Mailing Address - Country:US
Mailing Address - Phone:541-842-7705
Mailing Address - Fax:541-842-7640
Practice Address - Street 1:900 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-7136
Practice Address - Country:US
Practice Address - Phone:541-842-7640
Practice Address - Fax:541-842-7640
Is Sole Proprietor?:No
Enumeration Date:2015-06-16
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
ORC6030101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor