Provider Demographics
NPI:1689331084
Name:MALAMA COUNSELING SERVICES LLC
Entity Type:Organization
Organization Name:MALAMA COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KALI
Authorized Official - Middle Name:
Authorized Official - Last Name:IKEMOTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-292-9882
Mailing Address - Street 1:45-112 LELEUA PL
Mailing Address - Street 2:
Mailing Address - City:KANEOHE
Mailing Address - State:HI
Mailing Address - Zip Code:96744-2123
Mailing Address - Country:US
Mailing Address - Phone:808-292-9882
Mailing Address - Fax:
Practice Address - Street 1:1441 KAPIOLANI BLVD STE 1740
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-4402
Practice Address - Country:US
Practice Address - Phone:808-292-9882
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-19
Last Update Date:2021-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty