NPIMap

Individual provider Active NPI

Chevaun Brooks Petropulos

  • Mental Health Counselor
  • Wailuku, HI
National Provider Identifier
1538599170
Registry record updated Nov 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
81 N Market St
Suite 200
Wailuku, HI 96793-3700
Phone
(808) 344-7511
Fax
(808) 244-2254
NPI assigned
Nov 18, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2013

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 Primary

Addresses

Primary practice location

81 N Market St
Suite 200
Wailuku, HI 96793-3700

Mailing address

81 N Market St
Suite 200
Wailuku, HI 96793-3700
Phone (808) 344-7511

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Parents and Children Together Past 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1384732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384732800000",
    "number": "1538599170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81 N MARKET ST",
            "address_2": "SUITE 200",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "967933700",
            "telephone_number": "808-344-7511",
            "fax_number": "808-244-2254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 N MARKET ST",
            "address_2": "SUITE 200",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "967933700",
            "telephone_number": "808-344-7511",
            "fax_number": "808-244-2254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETROPULOS",
        "first_name": "CHEVAUN",
        "middle_name": "BROOKS",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-18",
        "last_updated": "2013-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wailuku, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2013; 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.