Healthcare Provider Details

I. General information

NPI: 1245606862
Provider Name (Legal Business Name): JOHN SHERWOOD CHEN-I CHOCK LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2015
Last Update Date: 01/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

438 HOBRON LN STE 315
HONOLULU HI
96815-1229
US

IV. Provider business mailing address

1948 NEHOA PL
HONOLULU HI
96822-3068
US

V. Phone/Fax

Practice location:
  • Phone: 808-284-0455
  • Fax: 808-564-0055
Mailing address:
  • Phone: 808-236-2600
  • Fax: 808-236-2626

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMHC-365
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: