| Davine Counseling Services, Llc | |
|
590 Farrington Highway #524-132 Kapolei HI 96707-2034 | |
| (808) 207-0637 | |
| (626) 565-2087 |
| Full Name | Davine Counseling Services, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 590 Farrington Highway #524-132, Kapolei, Hawaii |
| Authorized Official Name and Position | Jessica Wong (LCSW/THERAPIST) |
| Authorized Official Contact | 8082070637 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Davine Counseling Services, Llc Po Box 13056 Aiea HI 96701-8556 Ph: (808) 207-0637 | Davine Counseling Services, Llc 590 Farrington Highway #524-132 Kapolei HI 96707-2034 Ph: (808) 207-0637 |
| NPI Number | 1316601800 |
|---|---|
| Provider Enumeration Date | 10/29/2021 |
| Last Update Date | 09/05/2024 |
| Certification Date | 09/05/2024 |
| Medicare PECOS PAC ID | 2668861428 |
|---|---|
| Medicare Enrollment ID | O20211116002811 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316601800 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Jessica Johanna Nalani Wong |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629622576 PECOS PAC ID: 6002234093 Enrollment ID: I20200908001287 |
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