Provider Demographics
NPI:1285788992
Name:CONSTINE, BRENDA K (MA, LMHC, CSAC)
Entity type:Individual
Prefix:MS
First Name:BRENDA
Middle Name:K
Last Name:CONSTINE
Suffix:
Gender:F
Credentials:MA, LMHC, CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 383401
Mailing Address - Street 2:
Mailing Address - City:WAIKOLOA
Mailing Address - State:HI
Mailing Address - Zip Code:96738-3401
Mailing Address - Country:US
Mailing Address - Phone:808-969-9292
Mailing Address - Fax:808-969-7337
Practice Address - Street 1:400 HUALANI ST
Practice Address - Street 2:WAIAKEA VILLAS BLDG. 10 STE 195B
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-4378
Practice Address - Country:US
Practice Address - Phone:808-969-9292
Practice Address - Fax:808-969-7337
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1176-03101YA0400X
HI165101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI0770410OtherUHA