Provider Demographics
NPI:1518102250
Name:KAHALE, DESRAE K (NCC, LMHC)
Entity Type:Individual
Prefix:MISS
First Name:DESRAE
Middle Name:K
Last Name:KAHALE
Suffix:
Gender:F
Credentials:NCC, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 KAIMAKE LOOP
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-2017
Mailing Address - Country:US
Mailing Address - Phone:808-722-2437
Mailing Address - Fax:
Practice Address - Street 1:46-001 KAMEHAMEHA HWY
Practice Address - Street 2:#217
Practice Address - City:KANEOHE
Practice Address - State:HI
Practice Address - Zip Code:96744-3711
Practice Address - Country:US
Practice Address - Phone:808-722-2437
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-09
Last Update Date:2008-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI200101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health