Provider Demographics
NPI:1679272850
Name:THE CONSCIOUS MIND THERAPY LLC
Entity Type:Organization
Organization Name:THE CONSCIOUS MIND THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MARRIAGE FAMILY THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:
Authorized Official - Last Name:CANENCIA
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:808-389-8858
Mailing Address - Street 1:PO BOX 283029
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96828-3029
Mailing Address - Country:US
Mailing Address - Phone:808-389-8858
Mailing Address - Fax:
Practice Address - Street 1:3726 CRATER RD APT A
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-2346
Practice Address - Country:US
Practice Address - Phone:808-389-8858
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-27
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty