Gabriel Davis

Individual provider Active NPI Marriage & Family Therapist · Makawao, HI

NPI 1780119685 · NPPES record last updated Sep 24, 2021

Key facts

NPI
1780119685
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
724 (HI)
Practice address
81 Makawao Ave Ste 205
Makawao, HI 96768-8859
Phone
(808) 868-1208
NPI assigned
Apr 27, 2017
Sex
Male
Sole proprietor
Yes

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.

Medicare Care Compare profile

Specialty
Marriage and Family Therapist
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

17 Makai PL
Unit a
Kula, HI 96790-8518

17 Makai PL Unit a
Kula, HI 96790-8540

81 Makawao Ave
Suite 205
Makawao, HI 96768-8859
Phone (808) 868-1208

Medicare participation

Medicare fee-for-service enrollment
Enrolled in HI
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20251215000992 HI Practitioner - Marriage and Family Therapist 4183019904 Practice locations: Makawao, HI

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Carmen Cook Therapy, Inc. Current
since Dec 21, 2021
Accepting new patients

Locations

81 Makawao Ave
Ste 205
Makawao, HI 96768
Phone (808) 359-4448

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 724 HI Yes

Addresses

Primary practice location

81 Makawao Ave Ste 205
Makawao, HI 96768-8859

Mailing address

PO Box 27638
San Francisco, CA 94127-0638

Other providers in Makawao, HI

All providers in Makawao, HI · Marriage & Family Therapist in Hawaii

Sources for this page

Verify at the official NPI Registry.