Individual provider Active NPI

Lisa M Chun Fat, LMHC

  • Mental Health Counselor
  • Kapolei, HI
National Provider Identifier
1376940932
Registry record updated Dec 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MHC-340 Issued in HI
Practice address
2176 Lauwiliwili St Ste 1
Kapolei, HI 96707-1882
Phone
(808) 226-0616
NPI assigned
Nov 26, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2021

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-340 HI Primary

Addresses

Primary practice location

2176 Lauwiliwili St Ste 1
Kapolei, HI 96707-1882

Mailing address

2215 Booth Rd Apt a
Honolulu, HI 96813-6814
Phone (808) 226-0616

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

LicenseStateTypeSpecialty
MHC-340HIMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Lisa Chun Fat LLC Mental Health CurrentSince Jun 21, 2022 Accepting new patients
Family Tree Project, LLP Past Accepting new patients

Locations

2176 Lauwiliwili St
Ste 1
Kapolei, HI 96707
Phone (808) 202-0919

Interoperability endpoints

  • Direct secure messaging: lisa.fat@340371529072644.direct.elationemr.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1416960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640822400000",
    "number": "1376940932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2215 BOOTH RD APT A",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968136814",
            "telephone_number": "808-226-0616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2176 LAUWILIWILI ST STE 1",
            "city": "KAPOLEI",
            "state": "HI",
            "postal_code": "967071882",
            "telephone_number": "808-226-0616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUN FAT",
        "first_name": "LISA",
        "middle_name": "M",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-26",
        "last_updated": "2021-12-30",
        "certification_date": "2021-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "HI",
            "license": "MHC-340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kapolei, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2021; 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.