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200 N Vineyard Blvd Ste A325 Honolulu HI 96817-3950 | |
| (702) 350-1980 | |
| (808) 376-1054 |
| Full Name | |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 200 N Vineyard Blvd Ste A325, Honolulu, Hawaii |
| Authorized Official Name and Position | Rowell V. Laino (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7023501980 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
12232 Sea Voyage Ave Las Vegas NV 89138-4606 Ph: (702) 340-9188 | 200 N Vineyard Blvd Ste A325 Honolulu HI 96817-3950 Ph: (702) 350-1980 |
| NPI Number | 1285312777 |
|---|---|
| Provider Enumeration Date | 07/06/2023 |
| Last Update Date | 08/28/2024 |
| Certification Date | 08/28/2024 |
| Medicare PECOS PAC ID | 6709327257 |
|---|---|
| Medicare Enrollment ID | O20240924002238 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285312777 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Secondary |
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
| Provider Name | Rowena Santos Laino |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1578840070 PECOS PAC ID: 3173938198 Enrollment ID: I20241002003662 |
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