Provider Demographics
NPI:1790541530
Name:KAILUA COUNSELING SERVICES
Entity Type:Organization
Organization Name:KAILUA COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TYRA
Authorized Official - Middle Name:I
Authorized Official - Last Name:DAHLIN
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:808-782-8353
Mailing Address - Street 1:1233 ULUPII ST
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-4304
Mailing Address - Country:US
Mailing Address - Phone:808-782-8353
Mailing Address - Fax:
Practice Address - Street 1:1233 ULUPII ST
Practice Address - Street 2:
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-4304
Practice Address - Country:US
Practice Address - Phone:808-782-8353
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-27
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty