Individual provider Active NPI

Nicole Freeze, LMHC

  • Mental Health Counselor
  • Ewa Beach, HI
National Provider Identifier
1285474734
Registry record updated May 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MHC-1030 Issued in HI
Practice address
6478B 102ND St
Ewa Beach, HI 96706-3345
Phone
(330) 503-2995
NPI assigned
May 30, 2024
Last updated
May 30, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MHC-1030 HI Primary

Addresses

Primary practice location

6478B 102ND St
Ewa Beach, HI 96706-3345

Mailing address

6478B 102ND St
Ewa Beach, HI 96706-3345
Phone (330) 503-2995

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250521000361 HI Practitioner - Mental Health Counselor 3870011067 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MHC-1030HIMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Specialty Group PA Mental Health CurrentSince May 9, 2025 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.

NPI Registry JSON

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

{
    "created_epoch": "1717027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717027200000",
    "number": "1285474734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6478B 102ND ST",
            "city": "EWA BEACH",
            "state": "HI",
            "postal_code": "967063345",
            "telephone_number": "330-503-2995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6478B 102ND ST",
            "city": "EWA BEACH",
            "state": "HI",
            "postal_code": "967063345",
            "telephone_number": "330-503-2995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREEZE",
        "first_name": "NICOLE",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-30",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "HI",
            "license": "MHC-1030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ewa Beach, HI

Sources for this page

Verify at the official NPI Registry.