Healthcare Provider Details

I. General information

NPI: 1336882299
Provider Name (Legal Business Name): RACHEL LEWIS, LMFT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2022
Last Update Date: 04/19/2022
Certification Date: 04/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15-1724 27TH AVE
KEA'AU HI
96749
US

IV. Provider business mailing address

15-2689 MANALO ST. PAHOA HI 96778
PAHOA HI
96778
US

V. Phone/Fax

Practice location:
  • Phone: 808-431-3800
  • Fax:
Mailing address:
  • Phone: 808-431-3800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. RACHEL LEIGH LEWIS
Title or Position: OWNER
Credential: LMFT
Phone: 808-431-3800