Provider Demographics
NPI:1255655098
Name:LIPPERT, CHRISTINA SACHIE KULA (MFT, CSAC)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINA
Middle Name:SACHIE KULA
Last Name:LIPPERT
Suffix:
Gender:F
Credentials:MFT, CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1374 NUUANU AVE
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-4032
Mailing Address - Country:US
Mailing Address - Phone:808-537-7194
Mailing Address - Fax:808-547-4574
Practice Address - Street 1:1374 NUUANU AVE
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-4032
Practice Address - Country:US
Practice Address - Phone:808-537-7194
Practice Address - Fax:808-547-4574
Is Sole Proprietor?:No
Enumeration Date:2010-03-23
Last Update Date:2010-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1181-03101YA0400X
HI207106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)