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401 Kamakee St Ste 310 Honolulu HI 96814-4243 | |
| (808) 596-4555 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 401 Kamakee St Ste 310, Honolulu, Hawaii |
| Authorized Official Name and Position | Mark J Hovland (BOARD MEMBER) |
| Authorized Official Contact | 8085964555 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
401 Kamakee St Ste 310 Honolulu HI 96814-4243 Ph: (808) 596-4555 | 401 Kamakee St Ste 310 Honolulu HI 96814-4243 Ph: (808) 596-4555 |
| NPI Number | 1710236468 |
|---|---|
| Provider Enumeration Date | 09/07/2012 |
| Last Update Date | 02/27/2024 |
| Certification Date | 02/27/2024 |
| Medicare PECOS PAC ID | 2567802986 |
|---|---|
| Medicare Enrollment ID | O20240502002380 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710236468 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 313 (Hawaii) | Primary |
| Provider Name | Robert Okimura |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1093179673 PECOS PAC ID: 5991146623 Enrollment ID: I20240513003364 |
| Provider Name | Kent Takeo Kitagawa |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1093397911 PECOS PAC ID: 6901248954 Enrollment ID: I20240522003937 |
| Provider Name | Marguerite Paty Wolter |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1720481849 PECOS PAC ID: 4981046455 Enrollment ID: I20240529003257 |
| Provider Name | Mark Hovland |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1477706729 PECOS PAC ID: 6103266523 Enrollment ID: I20240625001747 |
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