Healthcare Provider Details

I. General information

NPI: 1295616100
Provider Name (Legal Business Name): MERIAH NICHOLS LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2025
Last Update Date: 09/09/2025
Certification Date: 09/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

911 WAIANUENUE AVE
HILO HI
96720-2018
US

IV. Provider business mailing address

911 WAIANUENUE AVE
HILO HI
96720-2018
US

V. Phone/Fax

Practice location:
  • Phone: 808-209-7131
  • Fax:
Mailing address:
  • Phone: 808-209-7131
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number1147
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: