Provider Demographics
NPI:1578968129
Name:FAMILY COUNSELING CENTER OF HAWAII, LLC
Entity Type:Organization
Organization Name:FAMILY COUNSELING CENTER OF HAWAII, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNY
Authorized Official - Middle Name:M
Authorized Official - Last Name:UNNO-LEE
Authorized Official - Suffix:
Authorized Official - Credentials:EDD, LMHC, NCC
Authorized Official - Phone:808-368-7410
Mailing Address - Street 1:98-030 HEKAHA ST
Mailing Address - Street 2:BLDG. 7, UNIT #3
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-4916
Mailing Address - Country:US
Mailing Address - Phone:808-368-7410
Mailing Address - Fax:808-487-7324
Practice Address - Street 1:98-030 HEKAHA ST
Practice Address - Street 2:BLDG. 7, UNIT #3
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-4916
Practice Address - Country:US
Practice Address - Phone:808-368-7410
Practice Address - Fax:808-487-7324
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-24
Last Update Date:2014-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI175101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty