| Mindful Living Group | |
|
1300 N Holopono St Ste 108 Kihei HI 96753-6946 | |
| (808) 206-9371 | |
| (855) 270-7441 |
| Full Name | Mindful Living Group |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 1300 N Holopono St Ste 108, Kihei, Hawaii |
| Authorized Official Name and Position | Marion Hart (BILLING & ADMINISTRATIVE DIRECTOR) |
| Authorized Official Contact | 8082834300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mindful Living Group Po Box 1977 Kihei HI 96753-1977 Ph: (855) 968-9371 | Mindful Living Group 1300 N Holopono St Ste 108 Kihei HI 96753-6946 Ph: (808) 206-9371 |
| NPI Number | 1881052298 |
|---|---|
| Provider Enumeration Date | 02/01/2016 |
| Last Update Date | 12/10/2023 |
| Certification Date | 12/10/2023 |
| Medicare PECOS PAC ID | 4183904188 |
|---|---|
| Medicare Enrollment ID | O20161208002465 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881052298 | NPI | - | NPPES |
| 800107 | Medicaid | HI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
| Provider Name | Molly W Palmer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750660767 PECOS PAC ID: 3779701693 Enrollment ID: I20140905001059 |
| Provider Name | Jessica Brazil |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881914497 PECOS PAC ID: 7517283278 Enrollment ID: I20150224002014 |
| Provider Name | Rigpa Shunya |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306154133 PECOS PAC ID: 0345466074 Enrollment ID: I20160712000939 |
| Provider Name | Jennifer H. Nill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508383753 PECOS PAC ID: 3476828278 Enrollment ID: I20171004001845 |
| Provider Name | Konstantina Rose |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285146761 PECOS PAC ID: 4385984673 Enrollment ID: I20190325000424 |
| Provider Name | Cailin Goodier |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033357058 PECOS PAC ID: 6103159611 Enrollment ID: I20190614000217 |
| Provider Name | Lynn M Porter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013085158 PECOS PAC ID: 0648604603 Enrollment ID: I20191227000660 |
| Provider Name | Rigpa Shunya |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306154133 PECOS PAC ID: 0345466074 Enrollment ID: I20200721004270 |
| Provider Name | Alicia Stettler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124561774 PECOS PAC ID: 9032529268 Enrollment ID: I20201112002172 |
| Provider Name | Sandra Diaz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487091831 PECOS PAC ID: 9830596451 Enrollment ID: I20210924001331 |
| Provider Name | Olajide Abiodun Opaleye |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992386304 PECOS PAC ID: 9830590843 Enrollment ID: I20221031000391 |
| Provider Name | Amanda Ford |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285375634 PECOS PAC ID: 5597125534 Enrollment ID: I20230721001792 |
| Provider Name | Nikima Glatt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730764887 PECOS PAC ID: 2961806468 Enrollment ID: I20230807000747 |
| Provider Name | Marla Mccall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437346707 PECOS PAC ID: 3971962390 Enrollment ID: I20230908003449 |
| Provider Name | Chase Conrad |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1346869385 PECOS PAC ID: 4284056896 Enrollment ID: I20240102000818 |
| Provider Name | Andrea Noel Vanpatten |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1790958874 PECOS PAC ID: 7012368731 Enrollment ID: I20240108000611 |
| Provider Name | Nancy A Morgan |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1205989449 PECOS PAC ID: 4183076276 Enrollment ID: I20240112004220 |
| Provider Name | Lauren Mai Kelly |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1225221369 PECOS PAC ID: 0345692497 Enrollment ID: I20240115000732 |
| Provider Name | Riitta Meera Ojala |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1366109977 PECOS PAC ID: 2365886850 Enrollment ID: I20240223001651 |
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