Individual provider Active NPI

Jasmine S Wong

  • Clinical Social Worker
  • Hilo, HI
National Provider Identifier
1902941511
Registry record updated Apr 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW-4437 Issued in HI
Practice address
345 Hoaka Rd
Hilo, HI 96720-3505
Phone
(808) 123-4567
NPI assigned
Feb 21, 2007
Last updated
Apr 8, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW-4437 HI Primary

Addresses

Primary practice location

345 Hoaka Rd
Hilo, HI 96720-3505

Mailing address

345 Hoaka Rd
Hilo, HI 96720-3505

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
I20191102000378 HI Practitioner - Clinical Social Worker 7416289905 Reassigns benefits to 1 organization
Practice locations: Hilo, HI

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW-4437HIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Living Aloha Counseling Services LLC Clinical CurrentSince Feb 1, 2024 Accepting new patients
Aloha House, Inc. Mental Health CurrentSince Jul 1, 2019 Accepting new patients

Locations

135 S Wakea Ave
Ste 201
Kahului, HI 96732
Phone (808) 242-1660

1787 Wili Pa Loop
Ste 7
Wailuku, HI 96793
Phone (808) 249-2121

Interoperability endpoints

  • Direct secure messaging: jwong12595@direct.uth.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712534400000",
    "number": "1902941511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 HOAKA RD",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967203505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 HOAKA RD",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967203505",
            "telephone_number": "808-123-4567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "JASMINE",
        "middle_name": "S",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-21",
        "last_updated": "2024-04-08",
        "certification_date": "2024-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "HI",
            "license": "LCSW-4437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hilo, HI

Sources for this page

Verify at the official NPI Registry.