| Cbt Gym | |
|
1164 Bishop St Ste 930 Honolulu HI 96813-6705 | |
| (808) 638-3870 | |
| (808) 829-3070 |
| Full Name | Cbt Gym |
|---|---|
| Speciality | Counselor |
| Location | 1164 Bishop St Ste 930, Honolulu, Hawaii |
| Authorized Official Name and Position | Justin Miller (OWNER) |
| Authorized Official Contact | 8086383870 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cbt Gym 1164 Bishop St Ste 930 Honolulu HI 96813-6705 Ph: (808) 638-3870 | Cbt Gym 1164 Bishop St Ste 930 Honolulu HI 96813-6705 Ph: (808) 638-3870 |
| NPI Number | 1316520927 |
|---|---|
| Provider Enumeration Date | 04/30/2021 |
| Last Update Date | 12/12/2021 |
| Certification Date | 12/12/2021 |
| Medicare PECOS PAC ID | 0446695076 |
|---|---|
| Medicare Enrollment ID | O20240305001599 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316520927 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Justin Craig Miller |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1699358291 PECOS PAC ID: 1355786989 Enrollment ID: I20240305001702 |
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