Provider Demographics
NPI:1093397911
Name:KITAGAWA, KENT TAKEO (LMHC)
Entity Type:Individual
Prefix:
First Name:KENT
Middle Name:TAKEO
Last Name:KITAGAWA
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98-1440 KOAHEAHE STREET
Mailing Address - Street 2:APT A
Mailing Address - City:PEARL CITY
Mailing Address - State:HI
Mailing Address - Zip Code:96782-2462
Mailing Address - Country:US
Mailing Address - Phone:808-286-0066
Mailing Address - Fax:
Practice Address - Street 1:401 KAMAKEE ST STE 306
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-4243
Practice Address - Country:US
Practice Address - Phone:808-596-4555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-21
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health