Healthcare Provider Details

I. General information

NPI: 1871905711
Provider Name (Legal Business Name): BEHAVIORAL AND THERAPEUTIC SERVICES OF HAWAII LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2014
Last Update Date: 09/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

710 PALEKAUA ST
HONOLULU HI
96816-4755
US

IV. Provider business mailing address

1330 WILDER AVE APT 319
HONOLULU HI
96822-4272
US

V. Phone/Fax

Practice location:
  • Phone: 808-780-0014
  • Fax: 808-356-1609
Mailing address:
  • Phone: 808-306-0429
  • Fax: 808-200-4978

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name: FRED KEKINO YUEN
Title or Position: MEMBER
Credential: M.S., B.C.B.A.
Phone: 808-780-0014