Healthcare Provider Details

I. General information

NPI: 1518493360
Provider Name (Legal Business Name): MELANIE KUSHI PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2017
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

91-3633 KAULUAKOKO ST UNIT 401
EWA BEACH HI
96706-5867
US

IV. Provider business mailing address

91-3633 KAULUAKOKO ST, UNIT 401
EWA BEACH HI
96706
US

V. Phone/Fax

Practice location:
  • Phone: 808-225-3903
  • Fax:
Mailing address:
  • Phone: 808-225-3903
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY-2343-0
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: