Active NPI
Mark Thomas Villanueva
- Clinical Social Worker
- Wahiawa, HI
National Provider Identifier
1265115224
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 5291
- Practice address
- PO Box 861684
Wahiawa, HI 96786-8563 - Phone
- (808) 220-7042
- NPI assigned
- Aug 8, 2023
- Last updated
- May 4, 2026
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 2523 | HI | |
| Clinical Social Worker | 1041C0700X | 12858-C | NV | |
| Clinical Social Worker | 1041C0700X | 5291 | HI | Primary |
Addresses
Primary practice location
PO Box 861684
Wahiawa, HI 96786-8563
Mailing address
PO Box 752123
Houston, TX 77275-2123
Phone (312) 476-9064
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in HI
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5291 | HI | MD | Clinical Social Worker |
| 12858-C | NV | MD | Clinical Social Worker |
| 2523 | HI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mental Health Specialty Group PA | Current | Accepting new patients |
Locations
500 Ala Moana Blvd
Ste 7400
Honolulu, HI 96813
Phone (617) 823-6490
Organizations & group practices 1
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.
-
dba Rula Health
- Mental Health Counselor
- Durham, NC
- NPI 1801472634
HI
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1691452800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1777852800000",
"number": "1265115224",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 752123",
"city": "HOUSTON",
"state": "TX",
"postal_code": "772752123",
"telephone_number": "312-476-9064"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "PO BOX 861684",
"city": "WAHIAWA",
"state": "HI",
"postal_code": "967868563",
"telephone_number": "808-220-7042"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VILLANUEVA",
"first_name": "MARK",
"middle_name": "THOMAS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-08-08",
"last_updated": "2026-05-04",
"certification_date": "2026-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "HI",
"license": "2523",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NV",
"license": "12858-C",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "HI",
"license": "5291",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wahiawa, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2026; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.