Healthcare Provider Details

I. General information

NPI: 1023809159
Provider Name (Legal Business Name): OHANA COUNSELING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2025
Last Update Date: 05/16/2025
Certification Date: 05/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15270 N BROOKSIDE LN SUITE 121
SURPRISE AZ
85374
US

IV. Provider business mailing address

15270 N BROOKSIDE LN SUITE 121
SURPRISE AZ
85374
US

V. Phone/Fax

Practice location:
  • Phone: 757-784-2384
  • Fax: 602-887-1494
Mailing address:
  • Phone: 757-784-2384
  • Fax: 602-887-1494

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER NOWELL HOLLOWAY
Title or Position: OWNER
Credential: LMFT
Phone: 757-784-2384