NPIMap

Organization Active NPI

Pacific Wellness, LLC

  • Counselor
  • Honolulu, HI
National Provider Identifier
1922415280
Registry record updated Dec 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
321 Issued in HI
Legal business name
PACIFIC WELLNESS, LLC
Practice address
401 Kamakee St
Suite 417
Honolulu, HI 96814-4203
Phone
(808) 372-1952
NPI assigned
Jul 18, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2014

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

Authorized official

Name
Melissa Hogan, LMHCNPI 1922444843
Title
Member
Phone
(808) 372-1952

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101Y00000X 321 HI Primary

Addresses

Primary practice location

401 Kamakee St
Suite 417
Honolulu, HI 96814-4203

Mailing address

401 Kamakee St
Suite 417
Honolulu, HI 96814-4203
Phone (808) 372-1952

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240131003458 HI Part B Supplier - Clinic/Group Practice 1557714029 Receives reassigned benefits from 1 practitioner
Practice locations: Honolulu, HI

National Provider Directory

National Provider Directory

Locations

401 Kamakee St
Ste 417
Honolulu, HI 96814
Phone (808) 369-0796

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1405641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418083200000",
    "number": "1922415280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 KAMAKEE ST",
            "address_2": "SUITE 417",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968144203",
            "telephone_number": "808-372-1952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 KAMAKEE ST",
            "address_2": "SUITE 417",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968144203",
            "telephone_number": "808-372-1952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-18",
        "last_updated": "2014-12-09",
        "status": "A",
        "authorized_official_last_name": "HOGAN",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "808-372-1952",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor",
            "state": "HI",
            "license": "321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Dec 9, 2014; 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.