Provider Demographics
NPI:1790225811
Name:HART, CHRIS BRIAN (RBT)
Entity Type:Individual
Prefix:MR
First Name:CHRIS
Middle Name:BRIAN
Last Name:HART
Suffix:
Gender:M
Credentials:RBT
Other - Prefix:MR
Other - First Name:CHRIS
Other - Middle Name:BRIAN
Other - Last Name:VALLES-MARTINEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RBT
Mailing Address - Street 1:ALOHA HOUSE, INC
Mailing Address - Street 2:200 IKE DR
Mailing Address - City:MAKAWAO
Mailing Address - State:HI
Mailing Address - Zip Code:96768
Mailing Address - Country:US
Mailing Address - Phone:808-249-2121
Mailing Address - Fax:
Practice Address - Street 1:200 IKE DR
Practice Address - Street 2:
Practice Address - City:MAKAWAO
Practice Address - State:HI
Practice Address - Zip Code:96768
Practice Address - Country:US
Practice Address - Phone:808-250-4581
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-08
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW80344101YM0800X, 104100000X
106S00000X
HI101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician