Provider Demographics
NPI:1578167565
Name:KILOUSKY, SCOTT (LMFT)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:
Last Name:KILOUSKY
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2163 PAUOA RD APT A
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-6535
Mailing Address - Country:US
Mailing Address - Phone:808-389-0119
Mailing Address - Fax:
Practice Address - Street 1:2163 PAUOA RD APT A
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-6535
Practice Address - Country:US
Practice Address - Phone:808-389-0119
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI671106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist