Provider Demographics
NPI:1811323074
Name:AYOOB, KATHRYN M (LMHC)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:M
Last Name:AYOOB
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:SALAAM
Other - Middle Name:
Other - Last Name:AYOOB
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 794
Mailing Address - Street 2:
Mailing Address - City:HOLUALOA
Mailing Address - State:HI
Mailing Address - Zip Code:96725-0794
Mailing Address - Country:US
Mailing Address - Phone:505-920-1192
Mailing Address - Fax:
Practice Address - Street 1:14-3433 SHELL RD
Practice Address - Street 2:
Practice Address - City:PAHOA
Practice Address - State:HI
Practice Address - Zip Code:96778-8161
Practice Address - Country:US
Practice Address - Phone:505-920-1192
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-19
Last Update Date:2025-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMHC-1107101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty