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General NPI Number Information
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NPI Number | 1770078784
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Entity Type | Organization
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Legal Business Name | MINDFUL HEALTH COUNSELING
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Dates
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Enumeration Date | 06/22/2018
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Last Update Date | 06/22/2018
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Provider Practice Location Address
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Address Line | 2200 MAIN ST STE 541
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City | WAILUKU
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State | HI
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Zip | 96793-1640
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Country | US
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Telephone | 808-280-3474
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Fax |
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Provider Business Mailing Address
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Address Line | 2200 MAIN ST STE 541
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City | WAILUKU
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State | HI
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Zip | 96793-1640
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Country | US
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Telephone | 808-280-3474
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | MR. KEITH W SCHERDT
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Credential | LMHC
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Telephone | 808-280-3474
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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 | 0450
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License Number State | HI
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