| Ka Hoku Kai Counseling Center, Llc | |
|
166 Kamehameha Ave Ste 1 Hilo HI 96720-2857 | |
| (808) 345-4863 | |
| Not Available |
| Full Name | Ka Hoku Kai Counseling Center, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 166 Kamehameha Ave Ste 1, Hilo, Hawaii |
| Authorized Official Name and Position | Jessica Elizabeth-rose Carroll (CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 8083454863 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ka Hoku Kai Counseling Center, Llc Po Box 711570 Mountain View HI 96771-1570 Ph: (808) 345-4863 | Ka Hoku Kai Counseling Center, Llc 166 Kamehameha Ave Ste 1 Hilo HI 96720-2857 Ph: (808) 345-4863 |
| NPI Number | 1043859200 |
|---|---|
| Provider Enumeration Date | 01/05/2020 |
| Last Update Date | 01/05/2020 |
| Certification Date | 01/05/2020 |
| Medicare PECOS PAC ID | 2961830633 |
|---|---|
| Medicare Enrollment ID | O20200311000426 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043859200 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
| Provider Name | Jessica Elizabeth-rose Carroll |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1306222401 PECOS PAC ID: 3870921547 Enrollment ID: I20200311000539 |
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