Provider Demographics
NPI:1114603834
Name:PROTEAN COUNSELING & CONSULTING HAWAII LLC
Entity Type:Organization
Organization Name:PROTEAN COUNSELING & CONSULTING HAWAII LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:GEORGE
Authorized Official - Last Name:PESANKA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:808-743-5024
Mailing Address - Street 1:200 KANOELEHUA AVE
Mailing Address - Street 2:PMB-347
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-4648
Mailing Address - Country:US
Mailing Address - Phone:808-743-5024
Mailing Address - Fax:
Practice Address - Street 1:200 KANOELEHUA AVE
Practice Address - Street 2:PMB-347
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720
Practice Address - Country:US
Practice Address - Phone:808-953-0181
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-27
Last Update Date:2023-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty