Active NPI
Selene Mersereau
- Marriage & Family Therapist
- Kailua, HI
National Provider Identifier
1679852966
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 263
- Practice address
- 970 N Kalaheo Ave
A310B
Kailua, HI 96734-1866 - Phone
- (808) 782-3110
- Fax
- (808) 263-0207
- NPI assigned
- Aug 4, 2011
- Last updated
- Aug 4, 2011
- 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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 263 | HI | Primary |
Addresses
Primary practice location
970 N Kalaheo Ave
A310B
Kailua, HI 96734-1866
Mailing address
970 N Kalaheo Ave
A310B
Kailua, HI 96734-1866
Phone (808) 782-3110
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 |
|---|---|---|---|
| 263 | HI | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Action With Aloha LLC | 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.
-
- Community/Behavioral Health Agency
- Honolulu, HI
- NPI 1174701361
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1312416000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1312416000000",
"number": "1679852966",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "970 N KALAHEO AVE",
"address_2": "A310B",
"city": "KAILUA",
"state": "HI",
"postal_code": "967341866",
"telephone_number": "808-782-3110",
"fax_number": "808-263-0207"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "970 N KALAHEO AVE",
"address_2": "A310B",
"city": "KAILUA",
"state": "HI",
"postal_code": "967341866",
"telephone_number": "808-782-3110",
"fax_number": "808-263-0207"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MERSEREAU",
"first_name": "SELENE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-08-04",
"last_updated": "2011-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "HI",
"license": "263",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kailua, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.