Healthcare Provider Details
I. General information
NPI: 1629930094
Provider Name (Legal Business Name): MADONNA TAUEU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 11/24/2025
Last Update Date: 01/23/2026
Certification Date: 01/23/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
91-2128 OLD FT WEAVER RD
EWA BEACH HI
96706-1911
US
IV. Provider business mailing address
91-2128 OLD FT WEAVER RD
EWA BEACH HI
96706-1911
US
V. Phone/Fax
- Phone: 808-754-9858
- Fax:
- Phone: 808-589-1829
- Fax: 808-589-2610
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | MHC-1190-0 |
| License Number State | HI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: