Individual and Relationship Counseling Center, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW 3013 Issued in HI

Legal business name

INDIVIDUAL AND RELATIONSHIP COUNSELING CENTER, LLC

Practice address

1504 Halekoa Dr
Honolulu, HI 96821-1125

Phone

(808) 735-1053

Fax

(808) 739-9183

NPI assigned

Dec 8, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jacqueline Winter, LCSW

Title

Psychotherapist

Phone

(808) 735-1053

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1083774319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1504 HALEKOA DR",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968211125",
            "telephone_number": "808-735-1053",
            "fax_number": "808-739-9183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1504 HALEKOA DR",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968211125",
            "telephone_number": "808-735-1053",
            "fax_number": "808-739-9183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIVIDUAL AND RELATIONSHIP COUNSELING CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WINTER",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "808-735-1053",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "HI",
            "license": "LCSW 3013",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW 3013",
            "identifier": "LCSW 3013",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.