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General NPI Number Information
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NPI Number | 1114218625
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Entity Type | Organization
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Legal Business Name | MENTAL HEALTH KOKUA
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Dates
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Enumeration Date | 05/02/2011
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Last Update Date | 11/13/2024
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Provider Practice Location Address
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Address Line | 680 IWILEI RD STE 600
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City | HONOLULU
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State | HI
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Zip | 96817-5393
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Country | US
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Telephone | 808-737-2523
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Fax |
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Provider Business Mailing Address
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Address Line | 680 IWILEI RD STE 600
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City | HONOLULU
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State | HI
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Zip | 96817-5393
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Country | US
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Telephone | 808-737-2523
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Fax | 808-734-1208
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Authorized Official
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Title or Position | CEO/ED
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Name | GREG PAYTON
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Credential |
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Telephone | 808-737-2523
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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