Provider Demographics
NPI:1457410532
Name:KAPOLEI COUNSELING LTD
Entity Type:Organization
Organization Name:KAPOLEI COUNSELING LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NADA
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:MANGIALETTI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:808-682-5808
Mailing Address - Street 1:91-110 HANUA ST
Mailing Address - Street 2:#208A
Mailing Address - City:KAPOLEI
Mailing Address - State:HI
Mailing Address - Zip Code:96707-1742
Mailing Address - Country:US
Mailing Address - Phone:808-682-5808
Mailing Address - Fax:808-682-5808
Practice Address - Street 1:91-110 HANUA ST
Practice Address - Street 2:#208A
Practice Address - City:KAPOLEI
Practice Address - State:HI
Practice Address - Zip Code:96707-1742
Practice Address - Country:US
Practice Address - Phone:808-682-5808
Practice Address - Fax:808-682-5808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI307103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI508654OtherHMA
HI420425OtherVALUE OPTIONS
HI1413644OtherUHA
HI01758802Medicaid
HI01758802OtherALOHACAREQUEST
HI508654OtherHMA
HI420425OtherVALUE OPTIONS