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General NPI Number Information
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NPI Number | 1518580505
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Entity Type | Organization
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Legal Business Name | RESILIENT MINDS LLC
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Dates
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Enumeration Date | 05/25/2020
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Last Update Date | 09/30/2021
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Provider Practice Location Address
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Address Line | 1029 KAPAHULU AVE
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City | HONOLULU
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State | HI
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Zip | 96816-1332
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Country | US
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Telephone | 808-372-3282
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 970772
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City | WAIPAHU
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State | HI
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Zip | 96797-0772
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Country | US
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Telephone | 808-781-4998
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Fax |
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Authorized Official
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Title or Position | LICENSED MENTAL HEALTH COUNSELOR
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Name | TIFFANY MILLER
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Credential | LMHC
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Telephone | 808-781-4998
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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