Healthcare Provider Details

I. General information

NPI: 1487200374
Provider Name (Legal Business Name): ALICIA FU CSAC,MSCP,LMHC,CCMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2019
Last Update Date: 01/06/2025
Certification Date: 01/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 KAMEHAMEHA HWY UNIT 962
PEARL CITY HI
96782-5042
US

IV. Provider business mailing address

PO BOX 962
PEARL CITY HI
96782-0962
US

V. Phone/Fax

Practice location:
  • Phone: 808-494-1528
  • Fax: 808-210-6095
Mailing address:
  • Phone: 808-392-3330
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: