Healthcare Provider Details

I. General information

NPI: 1922983725
Provider Name (Legal Business Name): MINDFUL GALLERY OF HAWAII LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2025
Last Update Date: 08/30/2025
Certification Date: 08/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1221 KAPIOLANI BLVD PH50
HONOLULU HI
96814
US

IV. Provider business mailing address

1221 KAPIOLANI BLVD PH 50
HONOLULU HI
96814-3518
US

V. Phone/Fax

Practice location:
  • Phone: 213-267-0803
  • Fax:
Mailing address:
  • Phone: 213-267-0803
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MRS. MIKA MAILANI CHANG
Title or Position: MENTAL HEALTH COUNSELOR
Credential: LMHC
Phone: 213-267-0803