Theresa Renee Wilson Hasting, LPC-S

Individual provider Active NPI Professional Counselor · Hilo, HI

NPI 1881024594 · NPPES record last updated Jan 11, 2023

Key facts

NPI
1881024594
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
61414 (TX)
Practice address
64 Keawe St Ste 204
Hilo, HI 96720-2486
Phone
(470) 655-6278
Fax
(877) 760-0394
NPI assigned
Nov 15, 2013
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Sep 28, 2024 through Sep 28, 2026

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
61414TXMDPharmacist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 61414 TX Yes

Addresses

Primary practice location

64 Keawe St Ste 204
Hilo, HI 96720-2486

Mailing address

64 Keawe St Ste 204
Hilo, HI 96720-2486
Phone (470) 655-6278

Other providers in Hilo, HI

All providers in Hilo, HI · Professional Counselor in Hawaii

Sources for this page

Verify at the official NPI Registry.