Healthcare Provider Details

I. General information

NPI: 1689290876
Provider Name (Legal Business Name): MICAH KOBAYASHI MS, LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2020
Last Update Date: 04/14/2025
Certification Date: 04/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2875 S KING ST STE 201A
HONOLULU HI
96826-3508
US

IV. Provider business mailing address

2875 S KING ST STE 201A
HONOLULU HI
96826-3508
US

V. Phone/Fax

Practice location:
  • Phone: 808-650-7473
  • Fax:
Mailing address:
  • Phone: 808-650-7473
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number852
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: