Provider Demographics
NPI:1841523552
Name:KELIIKULI, JAMIE LEE HAUNANI (MFT)
Entity type:Individual
Prefix:MS
First Name:JAMIE LEE
Middle Name:HAUNANI
Last Name:KELIIKULI
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:614 KILAUEA AVE STE 27
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-4253
Mailing Address - Country:US
Mailing Address - Phone:808-319-1903
Mailing Address - Fax:
Practice Address - Street 1:614 KILAUEA AVE STE 27
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-4253
Practice Address - Country:US
Practice Address - Phone:808-990-7181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-13
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMFT600106H00000X
101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor