Provider Demographics
NPI:1013662295
Name:HARA, SHAUN KIYOHISA (LMFT)
Entity type:Individual
Prefix:
First Name:SHAUN
Middle Name:KIYOHISA
Last Name:HARA
Suffix:
Gender:
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 KAMAKEE ST STE 406
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-4261
Mailing Address - Country:US
Mailing Address - Phone:808-542-9240
Mailing Address - Fax:
Practice Address - Street 1:2752 WOODLAWN DR STE 5-214
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96822-1855
Practice Address - Country:US
Practice Address - Phone:808-282-0156
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-16
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMFT-937106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist