Johanna Park

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

LMHC 427 Issued in HI

Legal business name

JOHANNA PARK

Practice address

120 Keawe St Ste 203B
Suite 202
Hilo, HI 96720-2874

Phone

(808) 315-1432

NPI assigned

Jan 27, 2017

Organization subpart

No

Name

Johanna Lynn Park, LMHCNPI 1063853299

Title

Owner

Phone

(808) 315-1432

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Johanna Park

  • Counselor
  • Hilo, HI
  • NPI 1063853299
  NPD Authorized official

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 17, 2025.

{
    "created_epoch": "1485475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765929600000",
    "number": "1093252124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16-566 KEAAU PAHOA RD STE 188-367",
            "city": "KEAAU",
            "state": "HI",
            "postal_code": "967498137",
            "telephone_number": "808-315-1432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 KEAWE ST STE 203B",
            "address_2": "SUITE 202",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967202874",
            "telephone_number": "808-315-1432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHANNA PARK",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-27",
        "last_updated": "2025-12-17",
        "certification_date": "2025-12-17",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "JOHANNA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "808-315-1432",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "HI",
            "license": "LMHC 427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Hilo, HI
• Community/Behavioral Health Agency in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2025; 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.