| Kintsugi Center For Healing Llc | |
|
98-211 Pali Momi St Ste 600 Aiea HI 96701-4337 | |
| (808) 201-9059 | |
| Not Available |
| Full Name | Kintsugi Center For Healing Llc |
|---|---|
| Speciality | Psychologist |
| Location | 98-211 Pali Momi St Ste 600, Aiea, Hawaii |
| Authorized Official Name and Position | Stephanie Phan (OWNER/CEO) |
| Authorized Official Contact | 4086144854 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kintsugi Center For Healing Llc 91-1014 Alepa St Kapolei HI 96707-1901 Ph: (408) 614-4854 | Kintsugi Center For Healing Llc 98-211 Pali Momi St Ste 600 Aiea HI 96701-4337 Ph: (808) 201-9059 |
| NPI Number | 1245002336 |
|---|---|
| Provider Enumeration Date | 10/23/2023 |
| Last Update Date | 10/23/2023 |
| Certification Date | 10/23/2023 |
| Medicare PECOS PAC ID | 0941658520 |
|---|---|
| Medicare Enrollment ID | O20231120002132 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245002336 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Stephanie Phan |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1114579687 PECOS PAC ID: 8224408745 Enrollment ID: I20221228000434 |
Val J. Umphress, Ph.d., Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 98-211 Pali Momi St, Suite 810, Aiea, HI 96701 Phone: 808-488-9288 Fax: 808-488-9288 | |
Tui L. Ulu Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 98-211 Pali Momi St, Suite 600, Aiea, HI 96701 Phone: 808-282-7201 | |
John P. Neuhaus, M.d., Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 99-128 Aiea Heights Drive, #301, Aiea, HI 96701 Phone: 808-723-9344 Fax: 808-312-4637 | |
Michele Wang, Md Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 99-128 Aiea Heights Dr Ste 109, Aiea, HI 96701 Phone: 424-234-3066 | |
Autism Behavior Consulting Group, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 99-950 Iwaena St Fl 2, Aiea, HI 96701 Phone: 808-277-7736 Fax: 808-748-0202 | |
Imua Health Group, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 99-080 Kauhale St Ste C20, Aiea, HI 96701 Phone: 808-953-4682 | |
Chelsea A Cordero Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 99-080 Kauhale St Ste C20, Aiea, HI 96701 Phone: 720-441-2515 |