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General NPI Number Information
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NPI Number | 1376982249
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Entity Type | Organization
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Legal Business Name | THERAPEUTIC COUNSELING CENTER
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Dates
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Enumeration Date | 06/24/2013
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Last Update Date | 06/24/2013
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Provider Practice Location Address
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Address Line | 1314 S KING ST SUITE 862
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City | HONOLULU
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State | HI
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Zip | 96814-1956
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Country | US
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Telephone | 808-388-0017
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Fax |
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Provider Business Mailing Address
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Address Line | 1314 S KING ST SUITE 862
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City | HONOLULU
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State | HI
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Zip | 96814-1956
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Country | US
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Telephone | 808-388-0017
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CHIYO MM CHURCHILL
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Credential | MFT
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Telephone | 808-388-0017
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 195
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License Number State | HI
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