Provider Demographics
NPI:1194098863
Name:OAHU COUNSELING AND WELLNESS CENTER
Entity type:Organization
Organization Name:OAHU COUNSELING AND WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MARRIGE AND FAMILY COUNSELOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:MALIA
Authorized Official - Middle Name:VIRGINIA
Authorized Official - Last Name:CABRAL
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:808-354-9898
Mailing Address - Street 1:2176 LAUWILIWILI ST STE 1
Mailing Address - Street 2:
Mailing Address - City:KAPOLEI
Mailing Address - State:HI
Mailing Address - Zip Code:96707-1882
Mailing Address - Country:US
Mailing Address - Phone:808-354-9898
Mailing Address - Fax:
Practice Address - Street 1:2176 LAUWILIWILI ST STE 1
Practice Address - Street 2:
Practice Address - City:KAPOLEI
Practice Address - State:HI
Practice Address - Zip Code:96707-1882
Practice Address - Country:US
Practice Address - Phone:808-354-9898
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-10
Last Update Date:2017-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI296106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty