NPI 1104574656 · live from the CMS NPI Registry
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Counselor, Mental Health in Kailua, HI. National Provider Identifier 1104574656, active.
NPI record
| NPI | 1104574656 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Counselor, Mental Health 101YM0800X |
| Practice location | 74 Kihapai St, Kailua, HI 96734 |
| Practice phone | 833-922-1092 |
| Enumerated | March 14, 2022 |
| Last updated | May 3, 2022 |
| Authorized official | Amy Yaeger, Mental Health Therapist/Owner |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Social Worker, Clinical | 1041C0700X | — |
| Counselor, Mental Health primary | 101YM0800X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.