Provider Demographics
NPI:1790291011
Name:KUKAHIWA-HARUNO, MICHAEL (MS, RBT-15-07111)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:
Last Name:KUKAHIWA-HARUNO
Suffix:
Gender:M
Credentials:MS, RBT-15-07111
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91-1081 IWIKUAMOO ST APT 1105
Mailing Address - Street 2:
Mailing Address - City:EWA BEACH
Mailing Address - State:HI
Mailing Address - Zip Code:96706-5810
Mailing Address - Country:US
Mailing Address - Phone:808-782-5456
Mailing Address - Fax:
Practice Address - Street 1:111 HEKILI ST STE A124
Practice Address - Street 2:
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-2800
Practice Address - Country:US
Practice Address - Phone:808-427-4750
Practice Address - Fax:808-909-2004
Is Sole Proprietor?:No
Enumeration Date:2017-12-21
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIRBT-15-07111106S00000X
HIMHC-726101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician