Gino Clinic, LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

GINO CLINIC, LLC

Doing business as

Gino Behavioral Health

Practice address

1188 Bishop St Ste 2905
Honolulu, HI 96813-3312

Phone

(808) 375-9867

Fax

(808) 450-2983

NPI assigned

Jun 12, 2024

Organization subpart

No

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

Authorized official

Name

Antonio Gino, PHDNPI 1679523153

Title

Owner

Phone

(808) 383-9834

Specialties & licenses 5

Addresses

Other identifiers 1

Other names 1

• Gino Behavioral Health Doing business as

Tax ID family

Gino Behavioral Health2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Gino Clinic

  • Psychologist
  • Honolulu, HI
  • NPI 1548527617
  NPD tax ID

Practitioners 1

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

• Antonio Gino, PH.D., CSAC

  • Clinical Psychologist
  • Honolulu, HI
  • NPI 1679523153
  NPD Authorized official

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

{
    "created_epoch": "1718150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718150400000",
    "number": "1649012295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25972",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968250972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1188 BISHOP ST STE 2905",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968133312",
            "telephone_number": "808-375-9867",
            "fax_number": "808-450-2983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GINO CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-12",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-07",
        "status": "A",
        "authorized_official_last_name": "GINO",
        "authorized_official_first_name": "ANTONIO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "808-383-9834",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "800250",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gino Behavioral Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Charles Warren Gima, ATC
• Lana H. Gimber, MD, MPH
• Gregory Gin
• Kriselle Gaea Miro Gines, MD
• Gino Clinic
• Alexander Gino
• Alissa Gino, LMHC
• Amanda Maria Gino
• Antonio Gino, PH.D., CSAC
• Peter Tsuneo Ginoza, MED

• Clinical Psychologist in Honolulu, HI
• Providers in Honolulu, HI by specialty
• Clinical Psychologist in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 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.