Provider Demographics
NPI:1811531338
Name:ALOHA MENTAL WELLNESS LLC
Entity type:Organization
Organization Name:ALOHA MENTAL WELLNESS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:LORILYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:LAUPOLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-664-1104
Mailing Address - Street 1:PO BOX 60599
Mailing Address - Street 2:
Mailing Address - City:EWA BEACH
Mailing Address - State:HI
Mailing Address - Zip Code:96706-7599
Mailing Address - Country:US
Mailing Address - Phone:808-664-1104
Mailing Address - Fax:866-592-3149
Practice Address - Street 1:928 NUUANU AVE LOWR LEVEL
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-5193
Practice Address - Country:US
Practice Address - Phone:808-664-1104
Practice Address - Fax:866-592-3149
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-29
Last Update Date:2024-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIRN01263OtherCERTIFICATE OF REGISTRATION FOR CONTROLLED SUBSTANCES/NARCOTICS ENFORCEMENT DIV.
WA2140004Medicaid
WA1659937878OtherNPI TYPE 1