Provider Demographics
NPI:1215332960
Name:TAKUSHI, MIKI (LMHC)
Entity type:Individual
Prefix:
First Name:MIKI
Middle Name:
Last Name:TAKUSHI
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98-535 LULU ST
Mailing Address - Street 2:
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-2166
Mailing Address - Country:US
Mailing Address - Phone:808-721-3544
Mailing Address - Fax:
Practice Address - Street 1:98-535 LULU ST
Practice Address - Street 2:
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-2166
Practice Address - Country:US
Practice Address - Phone:808-721-3544
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-23
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMHC-502101YM0800X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health