Active NPI
Danelle Medeiros
- Mental Health Counselor
- Kapolei, HI
National Provider Identifier
1659753622
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MHC123
- Practice address
- 1001 Kamokila Blvd 203
Kapolei, HI 96707-2014 - Phone
- (808) 387-3045
- Fax
- (808) 672-0104
- NPI assigned
- Jun 25, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MHC123 | HI | Primary |
Addresses
Primary practice location
1001 Kamokila Blvd 203
Kapolei, HI 96707-2014
Mailing address
92-7045 Kahea St
Kapolei, HI 96707-2302
Phone (808) 387-3922
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MHC123 | HI | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| DSM Therapeutic and Wellness Center LLC | Mental Health | Current | 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 and National Provider Directory roles.
-
- Mental Health Counselor
- Kapolei, HI
- NPI 1205216959
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1435190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1439164800000",
"number": "1659753622",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "92-7045 KAHEA ST",
"city": "KAPOLEI",
"state": "HI",
"postal_code": "967072302",
"telephone_number": "808-387-3922",
"fax_number": "808-672-0104"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1001 KAMOKILA BLVD 203",
"city": "KAPOLEI",
"state": "HI",
"postal_code": "967072014",
"telephone_number": "808-387-3045",
"fax_number": "808-672-0104"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDEIROS",
"first_name": "DANELLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-06-25",
"last_updated": "2015-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "HI",
"license": "MHC123",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kapolei, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.