MEDICARE: SEX THERAPY HAWAII, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist

General Provider Information

NPI Number	:	1124593504
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SEX THERAPY HAWAII, LLC

Provider Business Mailing Address
First Line	:	PO BOX 235292
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96823-3504
Country	:	US
Telephone Number	:	773-888-3312
Fax Number	:

Provider Business Practice Location Address
First Line	:	1600 KAPIOLANI BLVD STE 1340
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96814-3806
Country	:	US
Telephone Number	:	808-225-2780
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DR. JANET BRITO
Credential	:	PSY
Telephone Number	:	773-888-3312

Provider Enumeration Date	:	10/11/2018
Last Update Date	:	04/20/2022

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