Provider Demographics
NPI:1649827775
Name:HAMMOND, KEALAKAI-MALIE SUZANNE (LMHC)
Entity type:Individual
Prefix:
First Name:KEALAKAI-MALIE
Middle Name:SUZANNE
Last Name:HAMMOND
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:316 WYLLIE ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-1727
Mailing Address - Country:US
Mailing Address - Phone:808-286-3833
Mailing Address - Fax:
Practice Address - Street 1:316 WYLLIE ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-1727
Practice Address - Country:US
Practice Address - Phone:808-286-3833
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-22
Last Update Date:2019-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI439101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health