Healthcare Provider Details
I. General information
NPI: 1760736466
Provider Name (Legal Business Name): HOOLILO COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/01/2012
Last Update Date: 11/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
94-1221 KA UKA BLVD SUTE B206
WAIPAHU HI
96797-6202
US
IV. Provider business mailing address
PO BOX 37862
HONOLULU HI
96837-0862
US
V. Phone/Fax
- Phone: 808-664-1104
- Fax: 866-592-3149
- Phone: 808-664-1104
- Fax: 866-592-3149
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | LCSW3554 |
| License Number State | HI |
VIII. Authorized Official
Name:
PAMELA
SILVA
Title or Position: OWNER
Credential: LCSW
Phone: 808-664-1104