Healthcare Provider Details

I. General information

NPI: 1962449884
Provider Name (Legal Business Name): HAWAII COUNSELING & EDUCATION CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2006
Last Update Date: 01/26/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

970 N KALAHEO AVE SUITE C201
KAILUA HI
96734-1866
US

IV. Provider business mailing address

970 N KALAHEO AVE SUITE C201
KAILUA HI
96734-1866
US

V. Phone/Fax

Practice location:
  • Phone: 808-254-6484
  • Fax: 808-254-6427
Mailing address:
  • Phone: 808-254-6484
  • Fax: 808-254-6427

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name: SUSAN CATHERINE SICKORA
Title or Position: ADMINISTRATOR
Credential: RN, CSAC
Phone: 808-254-6484