1174988810 NPI number — MRS. MARYAM ARDEKANI CHAPMAN LMHCA

Table of content: MRS. MARYAM ARDEKANI CHAPMAN LMHCA (NPI 1174988810)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174988810 NPI number — MRS. MARYAM ARDEKANI CHAPMAN LMHCA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHAPMAN
Provider First Name:
MARYAM
Provider Middle Name:
ARDEKANI
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LMHCA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ARDEKANI
Provider Other First Name:
MARYAM
Provider Other Middle Name:
POORSHAKERI
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1174988810
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
370 HALELOA PL APT H
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HONOLULU
Provider Business Mailing Address State Name:
HI
Provider Business Mailing Address Postal Code:
96821-2273
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
425-941-6308
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
615 PIIKOI ST STE 203
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96814-3139
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-589-1829
Provider Business Practice Location Address Fax Number:
808-589-2610
Provider Enumeration Date:
12/23/2015

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  MC 60586807 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YM0800X , registered in the state of HI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)