Provider Demographics
NPI:1356172076
Name:STILL THERAPY LLC
Entity type:Organization
Organization Name:STILL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:AIYANA
Authorized Official - Middle Name:L
Authorized Official - Last Name:KANAKAOLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-825-4610
Mailing Address - Street 1:153 E KAMEHAMEHA AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:KAHULUI
Mailing Address - State:HI
Mailing Address - Zip Code:96732-3424
Mailing Address - Country:US
Mailing Address - Phone:808-825-4610
Mailing Address - Fax:808-825-4611
Practice Address - Street 1:711 SOUTH KAMEHAMEHA AVENUE
Practice Address - Street 2:APT. 3D6
Practice Address - City:KAHULUI
Practice Address - State:HI
Practice Address - Zip Code:96732
Practice Address - Country:US
Practice Address - Phone:808-825-4610
Practice Address - Fax:808-825-4611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-13
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health