Healthcare Provider Details

I. General information

NPI: 1457077869
Provider Name (Legal Business Name): DR. ANAIA LEILANI KEALI'I JOLIE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2022
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

945 N POINT DR # 1195
ALPHARETTA GA
30022-8266
US

IV. Provider business mailing address

945 N POINT DR # 1195
ALPHARETTA GA
30022-8266
US

V. Phone/Fax

Practice location:
  • Phone: 678-878-8227
  • Fax:
Mailing address:
  • Phone: 943-241-6433
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMF8591
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code102L00000X
TaxonomyPsychoanalyst
License NumberLMFT002100
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number245911
License Number StateAK
# 4
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number8348
License Number StateSC
# 5
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLF61438733
License Number StateWA
# 6
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLCM1145
License Number StateMD
# 7
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number160941
License Number StateCA
# 8
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number987
License Number StateHI
# 9
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number21073
License Number StateNC
# 10
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT002100
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: