Provider Demographics
NPI:1942529789
Name:KONG, ELIZABETH M (LMFT)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:M
Last Name:KONG
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 RICHARDS ST STE 600
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-4713
Mailing Address - Country:US
Mailing Address - Phone:808-722-7045
Mailing Address - Fax:808-892-3683
Practice Address - Street 1:850 RICHARDS ST STE 600
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-4713
Practice Address - Country:US
Practice Address - Phone:808-722-7045
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-19
Last Update Date:2023-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMFT 238106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI0000294363OtherHMSA
HI272605113OtherHAWAII MEDICAL ASSURANCE ASSOCIATION (HMAA)
HI272605113OtherUHA HEALTH INSURANCE
HI99726OtherTRICARE WEST
KS272605113OtherNEW HORIZONS BEHAVIORAL HEALTH
HI272605113OtherHAWAII WESTERN MEDICAL GROUP (MWMG)
HI737067Medicaid
HI000678397001OtherOPTUM BEHAVIOR HEALTH
HI4608703OtherAMERICAN FOREIGN BENEFIT