Provider Demographics
NPI:1013394097
Name:PLAYTER, AILEEN T (LMHC)
Entity type:Individual
Prefix:
First Name:AILEEN
Middle Name:T
Last Name:PLAYTER
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 1:1905 OAK AVE
Mailing Address - Street 2:
Mailing Address - City:NICEVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32578-3611
Mailing Address - Country:US
Mailing Address - Phone:808-344-1130
Mailing Address - Fax:
Practice Address - Street 1:99-149 MOANALUA RD STE 201
Practice Address - Street 2:
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-4001
Practice Address - Country:US
Practice Address - Phone:808-344-1130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-29
Last Update Date:2024-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X, 101YM0800X
HIMHC-630101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator