Active NPI
Amber Fitzgerald
- Mental Health Counselor
- Keaau, HI
National Provider Identifier
1053938415
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MHC-1116-0
- Practice address
- 16-1504 40TH Ave.
Keaau, HI 96749 - Phone
- (808) 640-3911
- NPI assigned
- Jul 1, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MHC-1116-0 | HI | Primary |
Addresses
Primary practice location
16-1504 40TH Ave.
Keaau, HI 96749
Mailing address
HC 2 Box 5815
Keaau, HI 96749-8400
Phone (808) 640-3911
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in HI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250606001824 | HI | Practitioner - Mental Health Counselor | 4082124250 | Practice locations: Keaau, HI |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MHC-1116-0 | HI | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1593561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1750032000000",
"number": "1053938415",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "HC 2 BOX 5815",
"city": "KEAAU",
"state": "HI",
"postal_code": "967498400",
"telephone_number": "808-640-3911"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16-1504 40TH AVE.",
"city": "KEAAU",
"state": "HI",
"postal_code": "96749",
"telephone_number": "808-640-3911"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FITZGERALD",
"first_name": "AMBER",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-07-01",
"last_updated": "2025-06-16",
"certification_date": "2025-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "HI",
"license": "MHC-1116-0",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Keaau, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.