NPIMap

Organization Active NPI

Trauma Recovery Psychotherapy Services Hawaii

  • Mental Health Counselor
  • Mililani, HI
National Provider Identifier
1407680713
Registry record updated Sep 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
TRAUMA RECOVERY PSYCHOTHERAPY SERVICES HAWAII
Practice address
95-1507 Ainamakua Dr Apt 30
Mililani, HI 96789-4406
Phone
(808) 829-1717
NPI assigned
Aug 28, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2024

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

Authorized official

Name
Mr. Lavon Petersen, MSW, LCSW, MPHNPI 1013650365
Title
Psychotherapist/Owner
Phone
(808) 798-5278

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

95-1507 Ainamakua Dr Apt 30
Mililani, HI 96789-4406

Mailing address

95-1507 Ainamakua Dr Apt 30
Mililani, HI 96789-4406
Phone (808) 829-1717

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1724803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726790400000",
    "number": "1407680713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95-1507 AINAMAKUA DR APT 30",
            "city": "MILILANI",
            "state": "HI",
            "postal_code": "967894406",
            "telephone_number": "808-829-1717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95-1507 AINAMAKUA DR APT 30",
            "city": "MILILANI",
            "state": "HI",
            "postal_code": "967894406",
            "telephone_number": "808-829-1717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRAUMA RECOVERY PSYCHOTHERAPY SERVICES HAWAII",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-28",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-20",
        "status": "A",
        "authorized_official_last_name": "PETERSEN",
        "authorized_official_first_name": "LAVON",
        "authorized_official_title_or_position": "PSYCHOTHERAPIST/OWNER",
        "authorized_official_telephone_number": "808-798-5278",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MSW, LCSW, MPH"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mililani, HI

Sources for this page

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

Verify at the official NPI Registry.