Provider Demographics
NPI:1487196226
Name:ON THE PATH COUNSELING, LLC
Entity type:Organization
Organization Name:ON THE PATH COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDERSSON-REICHERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-264-1234
Mailing Address - Street 1:21 B KEALALOA AVE
Mailing Address - Street 2:
Mailing Address - City:MAKAWAO
Mailing Address - State:HI
Mailing Address - Zip Code:96768
Mailing Address - Country:US
Mailing Address - Phone:808-264-1234
Mailing Address - Fax:
Practice Address - Street 1:21 B KEALALOA AVE
Practice Address - Street 2:
Practice Address - City:MAKAWAO
Practice Address - State:HI
Practice Address - Zip Code:96768
Practice Address - Country:US
Practice Address - Phone:808-264-1234
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-10
Last Update Date:2016-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI220106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty