Provider Demographics
NPI:1801189865
Name:LAU, JARED (PHD, NCC, LCMHC)
Entity Type:Individual
Prefix:DR
First Name:JARED
Middle Name:
Last Name:LAU
Suffix:
Gender:M
Credentials:PHD, NCC, LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98-380 KOAUKA LOOP APT 332
Mailing Address - Street 2:
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-4428
Mailing Address - Country:US
Mailing Address - Phone:808-277-3841
Mailing Address - Fax:
Practice Address - Street 1:98-380 KOAUKA LOOP APT 332
Practice Address - Street 2:
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-4428
Practice Address - Country:US
Practice Address - Phone:808-277-3841
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-24
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8529101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health