Brandt Shortland Te Koha Koi Shortland Jr., BSW
Individual provider Active NPI Counselor · Honolulu, HI
NPI 1164264644 · NPPES record last updated Jun 6, 2024
Key facts
- NPI
- 1164264644
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- Practice address
- 2045 Kamehameha Ave
Honolulu, HI 96822-2102 - Phone
- (808) 376-1608
- NPI assigned
- Jun 6, 2024
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Yes |
Addresses
Primary practice location
2045 Kamehameha Ave
Honolulu, HI 96822-2102
Mailing address
2045 Kamehameha Ave
Honolulu, HI 96822-2102
Phone (808) 376-1608
Other providers in Honolulu, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 6, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.