NPIMap

Organization Active NPI

Heavenly Star LLC

  • Clinical Social Worker
  • Aiea, HI
National Provider Identifier
1306201629
Registry record updated Dec 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
4054 Issued in HI
Legal business name
HEAVENLY STAR LLC
Practice address
99-124 Kohomua St
15C
Aiea, HI 96701-3876
Phone
(808) 781-7984
NPI assigned
Dec 31, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2015

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

Authorized official

Name
Rena Mae Nalani Takushi, LCSWNPI 1144685413
Title
Licensed Clinical Social Worker
Phone
(808) 781-7984

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 4054 HI Primary

Addresses

Primary practice location

99-124 Kohomua St
15C
Aiea, HI 96701-3876

Mailing address

99-124 Kohomua St
15C
Aiea, HI 96701-3876
Phone (808) 781-7984

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1451520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1451520000000",
    "number": "1306201629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99-124 KOHOMUA ST",
            "address_2": "15C",
            "city": "AIEA",
            "state": "HI",
            "postal_code": "967013876",
            "telephone_number": "808-781-7984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99-124 KOHOMUA ST",
            "address_2": "15C",
            "city": "AIEA",
            "state": "HI",
            "postal_code": "967013876",
            "telephone_number": "808-781-7984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEAVENLY STAR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-31",
        "last_updated": "2015-12-31",
        "status": "A",
        "authorized_official_last_name": "TAKUSHI",
        "authorized_official_first_name": "RENA MAE",
        "authorized_official_middle_name": "NALANI",
        "authorized_official_title_or_position": "LICENSED CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "808-781-7984",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "HI",
            "license": "4054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aiea, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 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.