| Aloha House, Inc. | |
|
1787 Wili Pa Loop Suite 7 Wailuku HI 96793-1280 | |
| (808) 249-2121 | |
| (808) 242-8920 |
| Full Name | Aloha House, Inc. |
|---|---|
| Speciality | Counselor |
| Location | 1787 Wili Pa Loop, Wailuku, Hawaii |
| Authorized Official Name and Position | Jud Cunningham (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 8085798414 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Aloha House, Inc. 1787 Wili Pa Loop Ste 7 Wailuku HI 96793-1271 Ph: (808) 249-2121 | Aloha House, Inc. 1787 Wili Pa Loop Suite 7 Wailuku HI 96793-1280 Ph: (808) 249-2121 |
| NPI Number | 1972647477 |
|---|---|
| Provider Enumeration Date | 02/16/2007 |
| Last Update Date | 09/01/2015 |
| Medicare PECOS PAC ID | 8426948316 |
|---|---|
| Medicare Enrollment ID | O20040316000630 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972647477 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Robert D Lanser |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033263785 PECOS PAC ID: 6608817887 Enrollment ID: I20050518000414 |
| Provider Name | David J Wittenberg |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1295800639 PECOS PAC ID: 4082657739 Enrollment ID: I20050603000887 |
| Provider Name | Margaret E Goldberg |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508901760 PECOS PAC ID: 1052331279 Enrollment ID: I20051202000520 |
| Provider Name | George L Carlson |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1598967119 PECOS PAC ID: 6002063161 Enrollment ID: I20120823000861 |
| Provider Name | Bahram Taghavi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1407058290 PECOS PAC ID: 0648206169 Enrollment ID: I20140905000719 |
| Provider Name | Connie J Debord |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699964775 PECOS PAC ID: 3173830262 Enrollment ID: I20150922003259 |
| Provider Name | Sharilyn Jane Butteling |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942726708 PECOS PAC ID: 4880935337 Enrollment ID: I20190409003670 |
| Provider Name | Joel Tapler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730594581 PECOS PAC ID: 5799026134 Enrollment ID: I20190411000968 |
| Provider Name | Jasmine Wong |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902941511 PECOS PAC ID: 7416289905 Enrollment ID: I20191102000378 |
| Provider Name | Arielle Nash |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174184014 PECOS PAC ID: 6709216013 Enrollment ID: I20200428000336 |
| Provider Name | Laurie Keiko Omuro-yamamoto |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1114071875 PECOS PAC ID: 7113222142 Enrollment ID: I20210302000162 |
| Provider Name | Sayaka K Reasoner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689167637 PECOS PAC ID: 7416348719 Enrollment ID: I20211221001717 |
| Provider Name | Sonya Beth Chambliss-alexander |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881995900 PECOS PAC ID: 5395103089 Enrollment ID: I20230628002315 |
| Provider Name | Max Dosland |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1033652029 PECOS PAC ID: 2264882273 Enrollment ID: I20240103000050 |
| Provider Name | Layin M Freeman |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1639283658 PECOS PAC ID: 0244682060 Enrollment ID: I20240117003438 |
| Provider Name | Vincent E Nubla |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1326234915 PECOS PAC ID: 9830533843 Enrollment ID: I20240219000387 |
| Provider Name | Kate Lauren Ulevich |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962963124 PECOS PAC ID: 9739528100 Enrollment ID: I20240417004011 |
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