Provider Demographics
NPI:1396806501
Name:CHAVEZ, DEBORAH M (PHD, MFT)
Entity type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:M
Last Name:CHAVEZ
Suffix:
Gender:F
Credentials:PHD, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 541
Mailing Address - Street 2:
Mailing Address - City:KAILUA KONA
Mailing Address - State:HI
Mailing Address - Zip Code:96745-0541
Mailing Address - Country:US
Mailing Address - Phone:808-322-9288
Mailing Address - Fax:855-242-0396
Practice Address - Street 1:75-5660 KOPIKO ST STE C7-424
Practice Address - Street 2:
Practice Address - City:KAILUA KONA
Practice Address - State:HI
Practice Address - Zip Code:96740-3611
Practice Address - Country:US
Practice Address - Phone:808-322-9288
Practice Address - Fax:855-242-0396
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI110106H00000X
HI1174103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist