MEDICARE: KOA COUNSELING, 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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1255264453
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KOA COUNSELING, LLC

Provider Business Mailing Address
First Line	:	1055 KALIHIWAI PL
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96825-1362
Country	:	US
Telephone Number	:	808-343-0093
Fax Number	:

Provider Business Practice Location Address
First Line	:	1055 KALIHIWAI PL
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96825-1362
Country	:	US
Telephone Number	:	808-343-0093
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	BRITT YOUNG
Credential	:	LMFT
Telephone Number	:	808-343-0093

Provider Enumeration Date	:	06/05/2026
Last Update Date	:	06/05/2026

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