=====================================================
General NPI Number Information
=====================================================
NPI Number | 1386206662
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | KR COUNSELING LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/08/2019
-----------------------------------------------------
Last Update Date | 07/08/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2200 MAIN ST STE 523
-----------------------------------------------------
City | WAILUKU
-----------------------------------------------------
State | HI
-----------------------------------------------------
Zip | 96793-1624
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 808-283-5752
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | POB0X 880293
-----------------------------------------------------
City | PUKALANI
-----------------------------------------------------
State | HI
-----------------------------------------------------
Zip | 96788-0293
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 808-283-5752
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MEMBER,
-----------------------------------------------------
Name | KARIN ROHR
-----------------------------------------------------
Credential | MA, HLMHP,
-----------------------------------------------------
Telephone | 808-283-5752
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------