Provider Demographics
NPI:1669725016
Name:PELAYO, CHRISTOPHER (LSW)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:PELAYO
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47-464 HOOPALA ST
Mailing Address - Street 2:
Mailing Address - City:KANEOHE
Mailing Address - State:HI
Mailing Address - Zip Code:96744-4876
Mailing Address - Country:US
Mailing Address - Phone:808-497-2147
Mailing Address - Fax:
Practice Address - Street 1:94-408 AKOKI ST
Practice Address - Street 2:STE. 202
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-2733
Practice Address - Country:US
Practice Address - Phone:808-676-5584
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-23
Last Update Date:2012-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI2006104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker