Provider Demographics
NPI:1952014672
Name:WEST COAST COUNSELING SERVICES LLC
Entity Type:Organization
Organization Name:WEST COAST COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:MOANA
Authorized Official - Middle Name:K
Authorized Official - Last Name:GASPAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-330-6611
Mailing Address - Street 1:91-1213 KANEONEO ST
Mailing Address - Street 2:
Mailing Address - City:KAPOLEI
Mailing Address - State:HI
Mailing Address - Zip Code:96707-4143
Mailing Address - Country:US
Mailing Address - Phone:808-330-6611
Mailing Address - Fax:
Practice Address - Street 1:91-1213 KANEONEO ST
Practice Address - Street 2:
Practice Address - City:KAPOLEI
Practice Address - State:HI
Practice Address - Zip Code:96707-4143
Practice Address - Country:US
Practice Address - Phone:808-330-6611
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-27
Last Update Date:2022-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI119434395OtherNPI TYPE 1
HI12751240OtherCAQH
HI101YM0800XOtherTAXONOMY
HI1033509633OtherNPI TYPE II
HI783870Medicaid