NPIMap

Organization Active NPI

Sweet Manoa LLC

Doing business as Manoa Canon Counseling Center

  • Mental Health Counselor
  • Honolulu, HI
National Provider Identifier
1730781394
Registry record updated Nov 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
SWEET MANOA LLC
Doing business as
Manoa Canon Counseling Center
Practice address
1050 Queen St Ste 100
Honolulu, HI 96814-4130
Phone
(808) 913-8840
NPI assigned
Nov 9, 2020
Last updated
Nov 9, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2020

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

Authorized official

Name
Hyungbum Kang, LCSWNPI 1447554787
Title
Director
Phone
(808) 913-8840

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Mental Health Counselor 101YM0800X Primary
Professional Counselor 101YP2500X
Clinical Psychologist 103TC0700X

Addresses

Primary practice location

1050 Queen St Ste 100
Honolulu, HI 96814-4130

Mailing address

909 Kapiolani Blvd Apt 1603
Honolulu, HI 96814-2139
Phone (808) 913-8840

Other names 1

  • Manoa Canon Counseling Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211208003289 HI Part B Supplier - Clinic/Group Practice 9638569544 Receives reassigned benefits from 2 practitioners
Practice locations: Honolulu, HI

National Provider Directory

National Provider Directory

Locations

1188 Bishop St
Ste 1007
Honolulu, HI 96813
Phone (808) 913-4184

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1604880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604880000000",
    "number": "1730781394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 KAPIOLANI BLVD APT 1603",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968142139",
            "telephone_number": "808-913-8840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 QUEEN ST STE 100",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968144130",
            "telephone_number": "808-913-8840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SWEET MANOA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-09",
        "last_updated": "2020-11-09",
        "certification_date": "2020-11-09",
        "status": "A",
        "authorized_official_last_name": "KANG",
        "authorized_official_first_name": "HYUNGBUM",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "808-913-8840",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Manoa Canon Counseling Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Honolulu, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2020; 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.