Individual provider Active NPI

Michael Kukahiwa-Haruno, MS, RBT-15-07111

  • Mental Health Counselor
  • Kailua, HI
National Provider Identifier
1790291011
Registry record updated Jul 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MHC-726 Issued in HI
Practice address
111 Hekili St Ste A124
Kailua, HI 96734-2800
Phone
(808) 427-4750
Fax
(808) 909-2004
NPI assigned
Dec 21, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-15-07111 HI
Mental Health Counselor 101YM0800X MHC-726 HI Primary

Addresses

Primary practice location

111 Hekili St Ste A124
Kailua, HI 96734-2800

Mailing address

91-1081 Iwikuamoo St Apt 1105
Ewa Beach, HI 96706-5810
Phone (808) 782-5456

Other practice location 1

550 Kunehi St Apt 205
Kapolei, HI 96707-2069
Phone (808) 780-0014

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240712000517 HI Practitioner - Mental Health Counselor 4183169311 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
MHC-726HIMDMental Health Counselor
RBT-15-07111HIMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Mindful Connections, LLC CurrentSince Jun 1, 2024 Accepting new patients
Mental Health Specialty Group PA Mental Health CurrentSince May 1, 2025 Accepting new patients

Locations

500 Ala Moana Blvd
Ste 7400
Honolulu, HI 96813
Phone (617) 823-6490

111 Hekili St
Ste A124
Kailua, HI 96734
Phone (808) 427-4750

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1513814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720656000000",
    "number": "1790291011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91-1081 IWIKUAMOO ST APT 1105",
            "city": "EWA BEACH",
            "state": "HI",
            "postal_code": "967065810",
            "telephone_number": "808-782-5456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 HEKILI ST STE A124",
            "city": "KAILUA",
            "state": "HI",
            "postal_code": "967342800",
            "telephone_number": "808-427-4750",
            "fax_number": "808-909-2004"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 Kunehi St Apt 205",
            "address_purpose": "LOCATION",
            "city": "Kapolei",
            "state": "HI",
            "postal_code": "967072069",
            "country_code": "US",
            "telephone_number": "808-780-0014",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUKAHIWA-HARUNO",
        "first_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "MS, RBT-15-07111",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-12-21",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "HI",
            "license": "RBT-15-07111",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "HI",
            "license": "MHC-726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kailua, HI

Sources for this page

Verify at the official NPI Registry.