Provider Demographics
NPI:1245957612
Name:A PATH TO HEAL THERAPY LLC
Entity type:Organization
Organization Name:A PATH TO HEAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LMFT
Authorized Official - Prefix:
Authorized Official - First Name:XAN
Authorized Official - Middle Name:KALEINANI
Authorized Official - Last Name:DECAMBRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-298-3143
Mailing Address - Street 1:468 POHEOHEO PL
Mailing Address - Street 2:
Mailing Address - City:KAHULUI
Mailing Address - State:HI
Mailing Address - Zip Code:96732-2510
Mailing Address - Country:US
Mailing Address - Phone:808-298-3143
Mailing Address - Fax:
Practice Address - Street 1:468 POHEOHEO PL
Practice Address - Street 2:
Practice Address - City:KAHULUI
Practice Address - State:HI
Practice Address - Zip Code:96732-2510
Practice Address - Country:US
Practice Address - Phone:808-298-3143
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-25
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty