Provider Demographics
NPI:1013402361
Name:HAWAII COMMUNITY COUNSELING SERVICES
Entity Type:Organization
Organization Name:HAWAII COMMUNITY COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ELLYN
Authorized Official - Middle Name:M
Authorized Official - Last Name:TONG
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:808-782-7342
Mailing Address - Street 1:4948 KILAUEA AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-5784
Mailing Address - Country:US
Mailing Address - Phone:808-782-7342
Mailing Address - Fax:
Practice Address - Street 1:98-1238 KAAHUMANU ST STE 302
Practice Address - Street 2:
Practice Address - City:PEARL CITY
Practice Address - State:HI
Practice Address - Zip Code:96782-3250
Practice Address - Country:US
Practice Address - Phone:808-782-7342
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-28
Last Update Date:2018-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HILMFT543251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health