Healthcare Provider Details

I. General information

NPI: 1124939087
Provider Name (Legal Business Name): RENE CONNOLLY MHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

988 HALEKAUWILA ST APT 4011
HONOLULU HI
96814-4064
US

IV. Provider business mailing address

988 HALEKAUWILA ST APT 4011
HONOLULU HI
96814-4064
US

V. Phone/Fax

Practice location:
  • Phone: 808-358-8538
  • Fax:
Mailing address:
  • Phone: 808-358-8538
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMHC-1228-0
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: