Provider Demographics
NPI:1104430123
Name:WHITTINGTON, ANTOINETTE KALEIWOHIOKALANI (MSCP, LMHC)
Entity type:Individual
Prefix:MRS
First Name:ANTOINETTE
Middle Name:KALEIWOHIOKALANI
Last Name:WHITTINGTON
Suffix:
Gender:F
Credentials:MSCP, LMHC
Other - Prefix:
Other - First Name:ANTOINETTE
Other - Middle Name:KALEIWOHIOKALANI
Other - Last Name:SPENCER-WHITTINGTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSCP
Mailing Address - Street 1:41-1452 LAUKALO ST
Mailing Address - Street 2:
Mailing Address - City:WAIMANALO
Mailing Address - State:HI
Mailing Address - Zip Code:96795-1282
Mailing Address - Country:US
Mailing Address - Phone:808-852-0421
Mailing Address - Fax:
Practice Address - Street 1:41-1452 LAUKALO ST
Practice Address - Street 2:
Practice Address - City:WAIMANALO
Practice Address - State:HI
Practice Address - Zip Code:96795-1282
Practice Address - Country:US
Practice Address - Phone:808-852-0421
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-08
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMCH699101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIMHC699OtherDCCA