Healthcare Provider Details

I. General information

NPI: 1104739473
Provider Name (Legal Business Name): ALYSSA MARIE OSKEY MORMANDO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/25/2026
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

213 KAWAIHAE ST APT 3
HONOLULU HI
96825-1916
US

IV. Provider business mailing address

1545 LOW COUNTRY BLVD
LELAND NC
28451-4515
US

V. Phone/Fax

Practice location:
  • Phone: 808-352-7613
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMHCP-59-0
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: