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General NPI Number Information
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NPI Number | 1467000257
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Entity Type | Individual
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Provider Name | SHAUN JESSE KASTELIC LMHC
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Gender | Male
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Dates
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Enumeration Date | 08/27/2019
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Last Update Date | 06/12/2020
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Provider Practice Location Address
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Address Line | 2207 OAHU AVE
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City | HONOLULU
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State | HI
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Zip | 96822-2210
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Country | US
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Telephone | 971-322-7871
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Fax |
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Provider Business Mailing Address
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Address Line | 46-315 IKIIKI ST
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City | KANEOHE
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State | HI
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Zip | 96744-4036
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Country | US
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Telephone | 971-322-7871
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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 | MHC305
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License Number State | HI
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