Healthcare Provider Details

I. General information

NPI: 1194640771
Provider Name (Legal Business Name): SUSTAIN YOUR MIND
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18-2037 OHIA NANI RD
MOUNTSIN VIEW HI
96771
US

IV. Provider business mailing address

PO BOX 6035
HILO HI
96720-8921
US

V. Phone/Fax

Practice location:
  • Phone: 808-480-1133
  • Fax:
Mailing address:
  • Phone: 808-480-1133
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: HEATHER MARIE WILLIAMS
Title or Position: CEO
Credential: LMHC
Phone: 808-480-1133