Healthcare Provider Details

I. General information

NPI: 1295541084
Provider Name (Legal Business Name): AKAHAI EMOTIONAL WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2024
Last Update Date: 12/05/2024
Certification Date: 12/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

154 WAIANUENUE AVE UNIT 11201
HILO HI
96721-2105
US

IV. Provider business mailing address

PO BOX 11201
HILO HI
96721-6201
US

V. Phone/Fax

Practice location:
  • Phone: 808-720-3637
  • Fax: 877-441-7008
Mailing address:
  • Phone: 808-720-3637
  • Fax: 877-441-7008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: MR. KEVIN LEE FAUST
Title or Position: MEMBER/MANAGER
Credential: LMHC
Phone: 808-720-3637