Healthcare Provider Details

I. General information

NPI: 1326928672
Provider Name (Legal Business Name): TRAUMA FREE ONLINE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2025
Last Update Date: 09/06/2025
Certification Date: 09/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1129 RYCROFT ST APT 203
HONOLULU HI
96814-2844
US

IV. Provider business mailing address

1129 RYCROFT ST APT 203
HONOLULU HI
96814-2844
US

V. Phone/Fax

Practice location:
  • Phone: 808-953-8603
  • Fax:
Mailing address:
  • Phone: 808-953-8603
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State

VIII. Authorized Official

Name: DR. MARTIN PHILLIPS
Title or Position: OWNER/MANAGER
Credential: MS CMHC, PHD
Phone: 808-953-8603