MEDICARE: EMILY ELIZABETH SPADACCINO

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1922931294
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY ELIZABETH SPADACCINO

Provider Business Mailing Address
First Line	:	188 HALE ST APT 1D
Second Line	:
City	:	HILO
State	:	HI
Zip	:	96720-2070
Country	:	US
Telephone Number	:	215-375-2234
Fax Number	:

Provider Business Practice Location Address
First Line	:	1045 KILAUEA AVE STE A
Second Line	:
City	:	HILO
State	:	HI
Zip	:	96720-4291
Country	:	US
Telephone Number	:	808-935-2188
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

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

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