Good Grief Clinic LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

GOOD GRIEF CLINIC LLC

Doing business as

Good Grief Clinic

Practice address

752 Lower Main St
Wailuku, HI 96793-1480

Phone

(808) 364-9391

NPI assigned

Aug 30, 2021

Last updated

Aug 30, 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

Mari M Kanemura, LCSWNPI 1326426727

Title

Clinic Director

Phone

(808) 364-9391

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Good Grief Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in HI

Enrollment records 1

Locations

Practitioners 3

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.

• Mari Kanemura, L.C.S.W.

  • Clinical Social Worker
  • Wailuku, HI
  • NPI 1326426727
  Medicare reassignment NPD Authorized official
• Lori Shinsato, LCSW

  • Clinical Social Worker
  • Wailuku, HI
  • NPI 1841708369
  NPD
• June Takako Tasuhara, PSYD

  • Psychologist
  • Wailuku, HI
  • NPI 1588740484
  NPD

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

{
    "created_epoch": "1630281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630281600000",
    "number": "1508534132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1731 KAMAMALU PL",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "967932505",
            "telephone_number": "808-364-9391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "752 LOWER MAIN ST",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "967931480",
            "telephone_number": "808-364-9391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD GRIEF CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-30",
        "last_updated": "2021-08-30",
        "certification_date": "2021-08-30",
        "status": "A",
        "authorized_official_last_name": "KANEMURA",
        "authorized_official_first_name": "MARI",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CLINIC DIRECTOR",
        "authorized_official_telephone_number": "808-364-9391",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "793085",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Good Grief Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Heather E Goff, MD
• Margaret E. Goldberg, LCSW, CSAC
• Jennifer Gonsalves
• Bennie Gonzales, PHARMD
• Stephanie A. Gonzalez
• Mary Goodwin-Downs
• Pamela R. Gordon, MD
• Joy Gorman, BA
• Krista R. Gorman, PA-C
• Mila Cortez Gorospe

• Clinical Social Worker in Wailuku, HI
• Providers in Wailuku, HI by specialty
• Clinical Social Worker in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.