Individual provider Active NPI

Christine Park, PHD, LMHC, NCC, CMP

  • Mental Health Counselor
  • Kaneohe, HI
National Provider Identifier
1386038842
Registry record updated Apr 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
282 Issued in HI
Practice address
46-1016 Emepela Way #22C
Kaneohe, HI 96744-3908
Phone
(808) 541-7536
NPI assigned
Mar 23, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 3, 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 282 HI Primary

Addresses

Primary practice location

46-1016 Emepela Way #22C
Kaneohe, HI 96744-3908

Mailing address

PO Box 1312
Keaau, HI 96749-1312
Phone (808) 989-6905

Other identifiers 1

IdentifierTypeStateIssuer
002080MedicaidHI

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
I20240126001748 HI Practitioner - Mental Health Counselor 4981057858 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
282HIMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Hiki No Counseling, LLC Mental Health CurrentSince Dec 27, 2023 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1427068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712102400000",
    "number": "1386038842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1312",
            "city": "KEAAU",
            "state": "HI",
            "postal_code": "967491312",
            "telephone_number": "808-989-6905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46-1016 EMEPELA WAY #22C",
            "city": "KANEOHE",
            "state": "HI",
            "postal_code": "967443908",
            "telephone_number": "808-541-7536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "CHRISTINE",
        "name_prefix": "Dr.",
        "credential": "PHD, LMHC, NCC, CMP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-23",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "HI",
            "license": "282",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002080",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kaneohe, HI

Sources for this page

Verify at the official NPI Registry.