Active NPI
Domonique A Hackney
- Mental Health Counselor
- Naalehu, HI
National Provider Identifier
1316786544
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MHCA.MC.61465055
- Practice address
- PO Box 721426
Naalehu, HI 96772-1119 - Phone
- (808) 977-0134
- NPI assigned
- May 20, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MHCA.MC.61465055 | WA | Primary |
Addresses
Primary practice location
PO Box 721426
Naalehu, HI 96772-1119
Mailing address
12022 167TH Dr NE Apt 3
Arlington, WA 98223-5861
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MHCA.MC.61465055 | WA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1716163200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1716163200000",
"number": "1316786544",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12022 167TH DR NE APT 3",
"city": "ARLINGTON",
"state": "WA",
"postal_code": "982235861"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "PO BOX 721426",
"city": "NAALEHU",
"state": "HI",
"postal_code": "967721119",
"telephone_number": "808-977-0134"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HACKNEY",
"first_name": "DOMONIQUE",
"middle_name": "A",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-05-20",
"last_updated": "2024-05-20",
"certification_date": "2024-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": "MHCA.MC.61465055",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Naalehu, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.