Provider Demographics
NPI:1265027148
Name:MAEHARA, AMANDA (LMHC)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:MAEHARA
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 DATE ST APT 201
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96826-4019
Mailing Address - Country:US
Mailing Address - Phone:808-382-2876
Mailing Address - Fax:
Practice Address - Street 1:95-1091 AINAMAKUA DR
Practice Address - Street 2:
Practice Address - City:MILILANI
Practice Address - State:HI
Practice Address - Zip Code:96789-4252
Practice Address - Country:US
Practice Address - Phone:808-204-4020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-03
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMHC-576101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NONEOtherNONE