| Dsm Therapeutic And Wellness Center Llc | |
|
91-1100 Paaoloulu Way Kapolei HI 96707-3102 | |
| (808) 387-3922 | |
| (808) 672-0104 |
| Full Name | Dsm Therapeutic And Wellness Center Llc |
|---|---|
| Speciality | Counselor |
| Location | 91-1100 Paaoloulu Way, Kapolei, Hawaii |
| Authorized Official Name and Position | Danelle S Medeiros (MEMBER MANAGER) |
| Authorized Official Contact | 8083873922 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dsm Therapeutic And Wellness Center Llc 92-7045 Kahea St Kapolei HI 96707-2302 Ph: (808) 387-3922 | Dsm Therapeutic And Wellness Center Llc 91-1100 Paaoloulu Way Kapolei HI 96707-3102 Ph: (808) 387-3922 |
| NPI Number | 1205216959 |
|---|---|
| Provider Enumeration Date | 06/08/2015 |
| Last Update Date | 06/08/2015 |
| Medicare PECOS PAC ID | 5597186619 |
|---|---|
| Medicare Enrollment ID | O20200528000812 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205216959 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (Hawaii) | Primary |
| 103TC1900X | Psychologist - Counseling | (Hawaii) | Secondary |
| 106H00000X | Marriage & Family Therapist | (Hawaii) | Secondary |
| Provider Name | George S Moises |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487140372 PECOS PAC ID: 5890116917 Enrollment ID: I20200528000664 |
| Provider Name | Joelle Branch |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942725940 PECOS PAC ID: 0941621346 Enrollment ID: I20200610000812 |
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