Provider Demographics
NPI:1699106765
Name:FEATHERS, JACKIE (MS, NCC)
Entity type:Individual
Prefix:MS
First Name:JACKIE
Middle Name:
Last Name:FEATHERS
Suffix:
Gender:F
Credentials:MS, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2090 HANALIMA ST.
Mailing Address - Street 2:BB204
Mailing Address - City:LIHUE
Mailing Address - State:HI
Mailing Address - Zip Code:96766
Mailing Address - Country:US
Mailing Address - Phone:785-285-1654
Mailing Address - Fax:
Practice Address - Street 1:4380 HANAMAULU RD
Practice Address - Street 2:
Practice Address - City:LIHUE
Practice Address - State:HI
Practice Address - Zip Code:96766-9162
Practice Address - Country:US
Practice Address - Phone:808-241-3165
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-27
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health