Provider Demographics
NPI:1154861573
Name:MAUNA KEA SKY COUNSELING LLC
Entity Type:Organization
Organization Name:MAUNA KEA SKY COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER, THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:SULLA
Authorized Official - Suffix:III
Authorized Official - Credentials:MFT, CSAC
Authorized Official - Phone:808-937-7323
Mailing Address - Street 1:PO BOX 1514
Mailing Address - Street 2:
Mailing Address - City:HONOKAA
Mailing Address - State:HI
Mailing Address - Zip Code:96727-1514
Mailing Address - Country:US
Mailing Address - Phone:808-937-7323
Mailing Address - Fax:808-933-3601
Practice Address - Street 1:64-1040 MAMALAHOA HWY
Practice Address - Street 2:SUITE 202
Practice Address - City:KAMUELA
Practice Address - State:HI
Practice Address - Zip Code:96743-8450
Practice Address - Country:US
Practice Address - Phone:808-937-7323
Practice Address - Fax:808-933-3601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-03
Last Update Date:2017-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMFT 423251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health