Jamal Fulani Wasan, PH.D

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MHC 9 Issued in HI

Practice address

76-6225 Kuakini Hwy
Hillside Plaza Suite B105
Kailua Kona, HI 96740-3211

Phone

(808) 883-0922

NPI assigned

Nov 13, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Clinical Psychologist

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lokahi Treatment CentersGroup PAC ID 7416936752, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Lokahi Treatment Centers

  • Addiction (Substance Use Disorder) Counselor
  • Waikoloa, HI
  • NPI 1073674602
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1427129196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68-1774 LAIE ST",
            "city": "WAIKOLOA",
            "state": "HI",
            "postal_code": "967385125",
            "telephone_number": "808-883-0922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76-6225 KUAKINI HWY",
            "address_2": "HILLSIDE PLAZA SUITE B105",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967403211",
            "telephone_number": "808-883-0922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASAN",
        "first_name": "JAMAL",
        "middle_name": "FULANI",
        "name_prefix": "Dr.",
        "credential": "PH.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "HI",
            "license": "MHC 9",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA-QUEST",
            "identifier": "0000596536",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Theresa Ihsin Wang, M.D.
• Walter J Wang, MD
• Cristina Maria Ward
• Michael Warnecke, BSN, RN
• Mary Katherine Warren, M.D.
• Michaela Watts, ND
• Richard Robert Watts, ATC
• Krista Anne Weber, CRNA
• David Weiner, LCSW
• Tiana L Weinmann

• Mental Health Counselor in Kailua Kona, HI
• Providers in Kailua Kona, HI by specialty
• Mental Health Counselor in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.