Healthcare Provider Details

I. General information

NPI: 1396081220
Provider Name (Legal Business Name): ZOEY LYNN FAUGHT MA, LMHCA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ZOEY LYNN LUXTON MA, LMHC

II. Dates (important events)

Enumeration Date: 12/20/2012
Last Update Date: 12/02/2020
Certification Date: 12/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15-1942 7TH AVE.
KEA'AU HI
96749
US

IV. Provider business mailing address

15-2662 PAHOA VILLAGE RD #306 PMB 8592
PAHOA HI
96778
US

V. Phone/Fax

Practice location:
  • Phone: 206-992-3636
  • Fax:
Mailing address:
  • Phone: 206-992-3636
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMC 60185652
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMHC474
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: