Provider Demographics
NPI:1568846772
Name:KEAMO, ALISON ALTALEA (LMHC)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:ALTALEA
Last Name:KEAMO
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 1:85-1373C WAIANAE VALLEY ROAD
Mailing Address - Street 2:
Mailing Address - City:WAIANAE
Mailing Address - State:HI
Mailing Address - Zip Code:96792
Mailing Address - Country:US
Mailing Address - Phone:808-469-7810
Mailing Address - Fax:
Practice Address - Street 1:85-1373 WAIANAE VALLEY RD APT C
Practice Address - Street 2:
Practice Address - City:WAIANAE
Practice Address - State:HI
Practice Address - Zip Code:96792-2572
Practice Address - Country:US
Practice Address - Phone:808-469-7810
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-17
Last Update Date:2023-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMHC-304101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health