Provider Demographics
NPI:1083449086
Name:KALEIDOSCOPE COUNSELING, LLC
Entity type:Organization
Organization Name:KALEIDOSCOPE COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:M
Authorized Official - Last Name:CANO-YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:808-353-1886
Mailing Address - Street 1:PO BOX 1034
Mailing Address - Street 2:
Mailing Address - City:KOLOA
Mailing Address - State:HI
Mailing Address - Zip Code:96756-1034
Mailing Address - Country:US
Mailing Address - Phone:808-353-1886
Mailing Address - Fax:
Practice Address - Street 1:3165 HIKINA RD
Practice Address - Street 2:
Practice Address - City:KOLOA
Practice Address - State:HI
Practice Address - Zip Code:96756-8500
Practice Address - Country:US
Practice Address - Phone:808-482-4434
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-07
Last Update Date:2024-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health