Johanna Park

Primary specialty

CounselorTaxonomy code 101Y00000X

License

MHC-427 Issued in HI

Practice address

399 E Kawili St Ste 202
Hilo, HI 96720-5075

Phone

(808) 315-1432

NPI assigned

Jul 16, 2013

Last updated

Mar 25, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Johanna Park

  • Community/Behavioral Health Agency
  • Hilo, HI
  • NPI 1093252124
  NPD Authorized official
• Well Mind LLC

  • Mental Health Counselor
  • Hilo, HI
  • NPI 1134466410
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1373932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585094400000",
    "number": "1063853299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6111",
            "city": "KAMUELA",
            "state": "HI",
            "postal_code": "967436111",
            "telephone_number": "808-315-1432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "399 E KAWILI ST STE 202",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967205075",
            "telephone_number": "808-315-1432"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "74-381 Kealakehe Pkwy Ste G",
            "address_purpose": "LOCATION",
            "city": "Kailua Kona",
            "state": "HI",
            "postal_code": "967402709",
            "country_code": "US",
            "telephone_number": "808-315-1432",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK",
        "first_name": "JOHANNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-16",
        "last_updated": "2020-03-25",
        "certification_date": "2020-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "HI",
            "license": "MHC-427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon Papalimu
• Paradise Retirement Hawaii LLC (Nanea Care)
• Danielle Paris-Larson
• Hoon Park, M.D.
• Hyo Park, MD
• Min Shik Park
• Moon Soo Park, M.D.
• Tasha HS Parker
• Kaycie Lynn Parks
• Jaime G Parra

• Counselor in Hilo, HI
• Providers in Hilo, HI by specialty
• Counselor in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.