Provider Demographics
NPI:1710687124
Name:DOMINGO, KELSEY TAMIKO ARAKAWA (LMHC)
Entity Type:Individual
Prefix:
First Name:KELSEY
Middle Name:TAMIKO ARAKAWA
Last Name:DOMINGO
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 1:95-226 KUKINI PL
Mailing Address - Street 2:
Mailing Address - City:MILILANI
Mailing Address - State:HI
Mailing Address - Zip Code:96789-5527
Mailing Address - Country:US
Mailing Address - Phone:808-232-7097
Mailing Address - Fax:
Practice Address - Street 1:99-128 AIEA HEIGHTS DR STE 309
Practice Address - Street 2:
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-3925
Practice Address - Country:US
Practice Address - Phone:808-488-9288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-06
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMHC-933-0101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health