Provider Demographics
NPI:1417387341
Name:BUKOSKI-GREEN, CATHERINE LOUISE (MA/MFT)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:LOUISE
Last Name:BUKOSKI-GREEN
Suffix:
Gender:F
Credentials:MA/MFT
Other - Prefix:MRS
Other - First Name:C. L.
Other - Middle Name:KAWAHINE
Other - Last Name:BUKOSKI-GREEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA/MFT
Mailing Address - Street 1:5903A OLOHENA RD
Mailing Address - Street 2:
Mailing Address - City:KAPAA
Mailing Address - State:HI
Mailing Address - Zip Code:96746-9723
Mailing Address - Country:US
Mailing Address - Phone:808-755-5657
Mailing Address - Fax:
Practice Address - Street 1:5903A OLOHENA RD
Practice Address - Street 2:
Practice Address - City:KAPAA
Practice Address - State:HI
Practice Address - Zip Code:96746-9723
Practice Address - Country:US
Practice Address - Phone:808-755-5657
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-13
Last Update Date:2013-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No104100000XBehavioral Health & Social Service ProvidersSocial Worker