Provider Demographics
NPI:1063232098
Name:REALSHIFT MENTAL HEALTH AND WELLNESS
Entity type:Organization
Organization Name:REALSHIFT MENTAL HEALTH AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHARIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:LABRIE
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:678-938-1585
Mailing Address - Street 1:3018 ALENCASTRE PL
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-1910
Mailing Address - Country:US
Mailing Address - Phone:678-938-1585
Mailing Address - Fax:
Practice Address - Street 1:91-3575 KAULUAKOKO ST UNIT 1606
Practice Address - Street 2:
Practice Address - City:EWA BEACH
Practice Address - State:HI
Practice Address - Zip Code:96706-5862
Practice Address - Country:US
Practice Address - Phone:678-938-1585
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-15
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty