Healthcare Provider Details

I. General information

NPI: 1922918572
Provider Name (Legal Business Name): JAMES LANCE HILTON MA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 BALDWIN AVE
PAIA HI
96779
US

IV. Provider business mailing address

5 WAIKALANI HEMA PL # 2L
KIHEI HI
96753-7351
US

V. Phone/Fax

Practice location:
  • Phone: 808-518-1619
  • Fax:
Mailing address:
  • Phone: 808-796-6855
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMHCP-62
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: