Start Fresh LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

LCSW-3958 Issued in HI

Legal business name

START FRESH LLC

Practice address

98-211 Pali Momi St Ste 635
Aiea, HI 96701-4322

Phone

(808) 232-4768

NPI assigned

Aug 29, 2014

Organization subpart

No

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

Authorized official

Name

Miss Samantha Sau Yu Fung, CSAC, LCSWNPI 1063645174

Title

Owner

Phone

(808) 232-4768

Specialties & licenses 2

Addresses

Practitioners 1

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

• Samantha Sau Yu Fung, CSAC, LCSW

  • Mental Health Counselor
  • Honolulu, HI
  • NPI 1063645174
  NPD (past) Authorized official

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

{
    "created_epoch": "1409270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411344000000",
    "number": "1942600770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1315 KALAKAUA AVE APT 907",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968261943",
            "telephone_number": "808-232-4768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "98-211 PALI MOMI ST STE 635",
            "city": "AIEA",
            "state": "HI",
            "postal_code": "967014322",
            "telephone_number": "808-232-4768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "START FRESH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-29",
        "last_updated": "2014-09-22",
        "status": "A",
        "authorized_official_last_name": "FUNG",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_middle_name": "SAU YU",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "808-232-4768",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "CSAC, LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "HI",
            "license": "LCSW-3958",
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "HI",
            "license": "CSAC 1809-14",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiffany Nicole Spierling, PHD
• James Springer, LCSW
• Madelyn Stagner
• Jazzlyn Standford
• Marisa Stanley
• Stayfit Physical Therapy LLC
• Stayfit Physical Therapy LLC
• Payge Stearns
• Lianne Ayaka Stephanos, MS, RD, LD, CDE
• Stephen K. Miyasato M.D., Inc.

• Community/Behavioral Health Agency in Aiea, HI
• Providers in Aiea, HI by specialty
• Community/Behavioral Health Agency in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.