Provider Demographics
NPI:1114435229
Name:TURNER-COOKE, KELLY
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:
Last Name:TURNER-COOKE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 IKE DR
Mailing Address - Street 2:
Mailing Address - City:MAKAWAO
Mailing Address - State:HI
Mailing Address - Zip Code:96768-9718
Mailing Address - Country:US
Mailing Address - Phone:808-579-8414
Mailing Address - Fax:
Practice Address - Street 1:1931 BALDWIN AVE
Practice Address - Street 2:
Practice Address - City:MAKAWAO
Practice Address - State:HI
Practice Address - Zip Code:96768-9761
Practice Address - Country:US
Practice Address - Phone:808-579-8414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-11
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor