Provider Demographics
NPI:1780489369
Name:GERINGER, JACQUELYN SUSAN (LMHC)
Entity type:Individual
Prefix:
First Name:JACQUELYN
Middle Name:SUSAN
Last Name:GERINGER
Suffix:
Gender:
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3161 ALA ILIMA ST APT 1213
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96818-3013
Mailing Address - Country:US
Mailing Address - Phone:808-798-2196
Mailing Address - Fax:
Practice Address - Street 1:95-390 KUAHELANI AVE STE 3AC
Practice Address - Street 2:
Practice Address - City:MILILANI
Practice Address - State:HI
Practice Address - Zip Code:96789-1190
Practice Address - Country:US
Practice Address - Phone:808-798-2196
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-17
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMHC-1087101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health