Supportive Care of Hawaii LLC
Organization Active NPI Mental Health Counselor · Honolulu, HI
NPI 1376384685 · NPPES record last updated Jun 3, 2024
Key facts
- NPI
- 1376384685
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Mental Health Counselor 101YM0800X
- Legal business name
- SUPPORTIVE CARE OF HAWAII LLC
- Practice address
- 1314 Piikoi St Apt 203
Honolulu, HI 96814-1140 - Phone
- (718) 506-1115
- NPI assigned
- Jun 3, 2024
- Organization subpart
- No
Authorized official
- Name
- Raphael Lichtschein
- Title
- President
- Phone
- (718) 298-4375
Practitioners 1
-
Flordeliza Maura Alonzo Herring, ED.D, LMHC, NCC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in HI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240726002349 | HI | Part B Supplier - Clinic/Group Practice | 5294271136 |
Receives reassigned benefits from 1 practitioner Practice locations: Honolulu, HI |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor |
101YM0800X | Yes | ||
| Clinical Psychologist |
103TC0700X | |||
| Clinical Social Worker |
1041C0700X | |||
| Nurse Practitioner |
363L00000X |
Addresses
Primary practice location
1314 Piikoi St Apt 203
Honolulu, HI 96814-1140
Mailing address
27 Randolph Rd
Howell, NJ 07731-8611
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All providers in Honolulu, HI · Mental Health Counselor in Hawaii
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 3, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.