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General NPI Number Information
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NPI Number | 1336767524
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Entity Type | Individual
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Provider Name | ALEXANDER ANDREAS KIRYAKAKIS LMHC
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Gender | Male
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Dates
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Enumeration Date | 07/14/2020
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Last Update Date | 09/18/2023
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Provider Practice Location Address
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Address Line | 1135 POHU ST
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City | HILO
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State | HI
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Zip | 96720-1657
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Country | US
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Telephone | 575-223-6891
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Fax |
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Provider Business Mailing Address
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Address Line | 1135 POHU ST
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City | HILO
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State | HI
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Zip | 96720-1657
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Country | US
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Telephone | 575-223-6891
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | T-CTL0211821
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MHC-956
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License Number State | HI
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