Provider Demographics
NPI:1831671437
Name:PONO COUNSELING SERVICES PLLC
Entity Type:Organization
Organization Name:PONO COUNSELING SERVICES PLLC
Other - Org Name:PONO COUNSELING SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LCSW
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:EMBRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-263-3085
Mailing Address - Street 1:1319 S WELDONA LN
Mailing Address - Street 2:
Mailing Address - City:SUPERIOR
Mailing Address - State:CO
Mailing Address - Zip Code:80027-8063
Mailing Address - Country:US
Mailing Address - Phone:720-307-2361
Mailing Address - Fax:
Practice Address - Street 1:1319 S WELDONA LN
Practice Address - Street 2:
Practice Address - City:SUPERIOR
Practice Address - State:CO
Practice Address - Zip Code:80027-8063
Practice Address - Country:US
Practice Address - Phone:720-307-2361
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-30
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health