Beacon of Lasting Change, LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

BEACON OF LASTING CHANGE, LLC

Practice address

438 Hobron LN Ste 311
Honolulu, HI 96815-1229

Phone

(808) 600-1132

NPI assigned

Dec 13, 2021

Last updated

Dec 13, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Maita Marks, LMFTNPI 1578931168

Title

Manager

Phone

(808) 600-1132

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Maita De Leon Marks, LMFT

  • Marriage & Family Therapist
  • Aiea, HI
  • NPI 1578931168
  NPD Authorized official

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

{
    "created_epoch": "1639353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639353600000",
    "number": "1396404877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5984 GANNET AVE",
            "city": "EWA BEACH",
            "state": "HI",
            "postal_code": "967063239",
            "telephone_number": "808-600-1132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "438 HOBRON LN STE 311",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968151229",
            "telephone_number": "808-600-1132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACON OF LASTING CHANGE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-13",
        "last_updated": "2021-12-13",
        "certification_date": "2021-12-13",
        "status": "A",
        "authorized_official_last_name": "MARKS",
        "authorized_official_first_name": "MAITA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "808-600-1132",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Glenn D Beachy, MS, ATC
• Eleane Marie Beadle, MD
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• Keola K. Beale, M.D.
• Liezl Zeta Beall, BSN-RN
• John Francis Beamis Jr., MD

• Adult Mental Health Clinic/Center in Honolulu, HI
• Providers in Honolulu, HI by specialty
• Adult Mental Health Clinic/Center in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 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.