Individual provider Active NPI

Kyle Michael Good, PH.D. M.ED. LMHC

  • Mental Health Counselor
  • Honolulu, HI
National Provider Identifier
1124349592
Registry record updated Aug 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MHC349 Issued in HI
Practice address
220 S King St
Suite 1170
Honolulu, HI 96813-4526
Phone
(808) 675-6108
Fax
(425) 820-1750
NPI assigned
Jun 18, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MHC349 HI Primary
Mental Health Counselor 101YM0800X LH60275244 WA

Addresses

Primary practice location

220 S King St
Suite 1170
Honolulu, HI 96813-4526

Mailing address

60 N Beretania St
#509
Honolulu, HI 96817-4752
Phone (808) 675-6108

Other identifiers 1

IdentifierTypeStateIssuer
826540100000OtherWAPREMERA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Education, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
MHC349HIMDMental Health Counselor
LH60275244WAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1276819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440460800000",
    "number": "1124349592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 N BERETANIA ST",
            "address_2": "#509",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968174752",
            "telephone_number": "808-675-6108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 S KING ST",
            "address_2": "SUITE 1170",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968134526",
            "telephone_number": "808-675-6108",
            "fax_number": "425-820-1750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOOD",
        "first_name": "KYLE",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "PH.D. M.ED. LMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-18",
        "last_updated": "2015-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "HI",
            "license": "MHC349",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH60275244",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREMERA",
            "identifier": "826540100000",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2015; 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.