Provider Demographics
NPI:1154727170
Name:HUMPHREYS, JOANNE (LMFT)
Entity type:Individual
Prefix:
First Name:JOANNE
Middle Name:
Last Name:HUMPHREYS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99-115 AIEA HEIGHTS DR
Mailing Address - Street 2:
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-3924
Mailing Address - Country:US
Mailing Address - Phone:808-533-2394
Mailing Address - Fax:
Practice Address - Street 1:99-115 AIEA HEIGHTS DR STE 219A
Practice Address - Street 2:
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-3974
Practice Address - Country:US
Practice Address - Phone:808-533-2394
Practice Address - Fax:808-909-3818
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-18
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI419106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist