| Mindful Roots Therapy Llc | |
|
200 N Vineyard Blvd # A3255554 Honolulu HI 96817-3950 | |
| (408) 320-7278 | |
| Not Available |
| Full Name | Mindful Roots Therapy Llc |
|---|---|
| Speciality | Social Worker |
| Location | 200 N Vineyard Blvd # A3255554, Honolulu, Hawaii |
| Authorized Official Name and Position | Rachael F Hawkins (LCSW , OWNER) |
| Authorized Official Contact | 4083207278 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mindful Roots Therapy Llc Po Box 3064 Kailua Kona HI 96745-3064 Ph: (408) 320-7278 | Mindful Roots Therapy Llc 200 N Vineyard Blvd # A3255554 Honolulu HI 96817-3950 Ph: (408) 320-7278 |
| NPI Number | 1427733864 |
|---|---|
| Provider Enumeration Date | 06/21/2023 |
| Last Update Date | 03/18/2024 |
| Certification Date | 03/18/2024 |
| Medicare PECOS PAC ID | 0941660252 |
|---|---|
| Medicare Enrollment ID | O20240226001847 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427733864 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Rachael Hawkins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841360906 PECOS PAC ID: 4284876350 Enrollment ID: I20130820000720 |
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