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General NPI Number Information
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NPI Number | 1285933960
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Entity Type | Organization
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Legal Business Name | COUNSELING AND WELLNESS SERVICES, LLC
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Dates
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Enumeration Date | 03/21/2011
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Last Update Date | 03/21/2011
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Provider Practice Location Address
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Address Line | 300 WAI NANI WAY APT 1415
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City | HONOLULU
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State | HI
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Zip | 96815-3983
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Country | US
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Telephone | 808-351-0447
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Fax |
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Provider Business Mailing Address
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Address Line | 300 WAI NANI WAY APT. 1415
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City | HONOLULU
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State | HI
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Zip | 96815-3983
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Country | US
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Telephone | 808-351-0447
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Fax |
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | DR. MELISSA N GREEN
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Credential | PSY.D.
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Telephone | 808-351-0447
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | PSY-1126
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License Number State | HI
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