Provider Demographics
NPI:1023153707
Name:TSUNEYOSHI, NAOMI RUTH (MC MENTAL HEALTH COU)
Entity type:Individual
Prefix:
First Name:NAOMI
Middle Name:RUTH
Last Name:TSUNEYOSHI
Suffix:
Gender:F
Credentials:MC MENTAL HEALTH COU
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4370 KUKUI GROVE STREET
Mailing Address - Street 2:SUITE 3-211
Mailing Address - City:LIHUE
Mailing Address - State:HI
Mailing Address - Zip Code:96766
Mailing Address - Country:US
Mailing Address - Phone:808-274-3190
Mailing Address - Fax:808-274-3194
Practice Address - Street 1:4370 KUKUI GROVE STREET
Practice Address - Street 2:SUITE 3-211
Practice Address - City:LIHUE
Practice Address - State:HI
Practice Address - Zip Code:96766
Practice Address - Country:US
Practice Address - Phone:808-274-3190
Practice Address - Fax:808-274-3194
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2015-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMHC164101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI53937201Medicaid