Provider Demographics
NPI:1821638511
Name:MOORE, TOMI NOHEALANI (LMHC)
Entity Type:Individual
Prefix:
First Name:TOMI
Middle Name:NOHEALANI
Last Name:MOORE
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 1:55-545 NANILOA LOOP
Mailing Address - Street 2:
Mailing Address - City:LAIE
Mailing Address - State:HI
Mailing Address - Zip Code:96762-1239
Mailing Address - Country:US
Mailing Address - Phone:808-779-2931
Mailing Address - Fax:
Practice Address - Street 1:875 WAIMANU ST STE 620
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-5267
Practice Address - Country:US
Practice Address - Phone:808-779-2931
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-09
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMHC-649101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health