Healthcare Provider Details

I. General information

NPI: 1558291732
Provider Name (Legal Business Name): HONU KAI PRACTICE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 W HIGHWAY 50 STE J
O FALLON IL
62269-1827
US

IV. Provider business mailing address

228 S RIEBELING ST
COLUMBIA IL
62236-2025
US

V. Phone/Fax

Practice location:
  • Phone: 314-856-3348
  • Fax:
Mailing address:
  • Phone: 314-856-3348
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: ADAM G WOEHLKE
Title or Position: OWNER/THERAPIST
Credential: LCPC
Phone: 314-856-3348