JOHANNA PARK (NPI# 1063853299) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063853299 |
| Entity Type | Individual |
| Full Name | JOHANNA PARK |
| Practice Address |
399 E Kawili St Ste 202 Hilo HI 96720-5075 |
| Mailing Address |
Po Box 6111 Kamuela HI 96743-6111 |
| Practice Telephone | 8083151432 |
| Mailing Telephone | 8083151432 |
| Enumeration Date | 2013-07-16 |
| Last Update Date | 2020-03-25 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | MHC-427 | HI | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 74-381 Kealakehe Pkwy Ste G, Kailua Kona, HI 967402709 | 8083151432 |
| Street Address |
399 E KAWILI ST STE 202 |
| City | HILO |
| State | HI |
| Zip Code | 96720-5075 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588177810 | Melissa K Kanemitsu | Marriage & Family Therapist | 399 E Kawili St Ste 202, Hilo, HI 96720-5075 | 2017-11-08 |
| 1710490040 | Melissa K Kanemitsu Lmft | Community/Behavioral Health | 399 E Kawili St Ste 202, Hilo, HI 96720-5075 | 2017-11-08 |
| 1265945687 | Starting Point Counseling Services | Community/Behavioral Health | 399 E Kawili St Ste 202, Hilo, HI 96720-5075 | 2017-11-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184230807 | Iane Dantas Franca | Counselor | 1045 Kilauea Avenue, Hilo, HI 96720 | 2020-09-17 |
| 1467086280 | Integrated Medicine Institute, Inc. | Nurse Practitioner | 868 Ululani Street Suite 106, Hilo, HI 96720 | 2020-03-02 |
| 1316405004 | Stephanie M Higa | Registered Nurse | Hc01 Stainback Hwy., Hilo, HI 96720 | 2019-03-12 |
| 1790257418 | Blake Honda | Behavior Technician | 879b Manono St., Hilo, HI 96720 | 2018-12-19 |
| 1184101446 | The Salvation Army | Substance Abuse Rehabilitation Facility | 105 Hokulani Street, Hilo, HI 96720 | 2018-07-19 |
| 1013434505 | Taliesin Erika Kiele Sumner | Student in an Organized Health Care Education/Training Program | 214 Waianueanue Ave., #209, Hilo, HI 96720 | 2017-08-24 |
| 1154844454 | David Fundakowski | Behavioral Analyst | 69 Railroad Avenue, Hawaii Behavioral Health, Hilo, HI 96720 | 2017-07-19 |
| 1407381668 | Veronica Brockway | Counselor | 69 Railroad Ave Ste 3, Hilo, HI 96720 | 2017-04-25 |
| 1477092682 | Frederique Montpetit | Student in an Organized Health Care Education/Training Program | 1257 Kilauea Ave Suite 100, Hilo Family Dental Center, Hilo, HI 96720 | 2017-02-21 |
| 1427592666 | Amber Kainoa Arthur | Behavioral Analyst | 234 Waianuenue Ave. Suite 215, Hilo, HI 96720 | 2016-12-07 |
| Find all providers in zip 96720 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063937506 | Jacqueline Goolian Yuw | Counselor | 69 Railroad Ave Unit 6, Hilo, HI 96720-7509 | 2017-08-06 |
| 1821523655 | Nickelina Townsend | Counselor | 1339 Makani St, Hilo, HI 96720-3495 | 2017-04-30 |
| 1437557592 | Benjamin Aron Mayer | Counselor | 121 Barenaba Ln, Hilo, HI 96720-4217 | 2014-12-05 |
| 1215284948 | Gerlinde Morris | Counselor | 952 Kumukoa St, Hilo, HI 96720-4029 | 2012-08-13 |
| 1104199132 | Renee Shutt | Counselor | 28 W Lanikaula St, Hilo, HI 96720-7203 | 2012-02-22 |
| 1447523428 | Sheila Schott | Counselor | 146 Puueo St, Hilo, HI 96720-2429 | 2012-02-21 |
| 1396018370 | Jessica N Harris | Counselor | 380 Akolea Rd, Hilo, HI 96720-1522 | 2012-02-21 |
| 1285907261 | Gavin S Pavao | Counselor | 570 Akolea Rd, Hilo, HI 96720-1511 | 2012-02-21 |
| 1831462811 | Gavin-john K Mata | Counselor | 2706 Pulima Dr, Hilo, HI 96720-1331 | 2012-02-21 |
| 1306119383 | Joshua Endriss | Counselor | 56 Kanoelani St, Hilo, HI 96720-5419 | 2012-02-21 |
| Find all providers in HILO | ||||
Please comment or provide details below to improve the information on JOHANNA PARK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.