Provider Demographics
NPI:1124714555
Name:NAUTILUS COUNSELING HAWAII LLC
Entity type:Organization
Organization Name:NAUTILUS COUNSELING HAWAII LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHIMOKAWA
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:808-280-0257
Mailing Address - Street 1:352 S HIGH ST
Mailing Address - Street 2:
Mailing Address - City:WAILUKU
Mailing Address - State:HI
Mailing Address - Zip Code:96793-2104
Mailing Address - Country:US
Mailing Address - Phone:808-280-0257
Mailing Address - Fax:
Practice Address - Street 1:285 W KAAHUMANU AVE
Practice Address - Street 2:
Practice Address - City:KAHULUI
Practice Address - State:HI
Practice Address - Zip Code:96732-1623
Practice Address - Country:US
Practice Address - Phone:808-280-0257
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-18
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty