Healthcare Provider Details

I. General information

NPI: 1427401264
Provider Name (Legal Business Name): KEANIMAIKALANI HUEU LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2016
Last Update Date: 08/15/2026
Certification Date: 08/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

941 KAMEHAMEHA HWY STE 204
PEARL CITY HI
96782-2516
US

IV. Provider business mailing address

1846 HOOLAULEA ST
PEARL CITY HI
96782-1718
US

V. Phone/Fax

Practice location:
  • Phone: 808-282-7564
  • Fax:
Mailing address:
  • Phone: 808-282-7564
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFT602
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: