Provider Demographics
NPI:1902614654
Name:SUSTAIN YOUR MIND
Entity type:Organization
Organization Name:SUSTAIN YOUR MIND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:DESENSI
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:808-480-1133
Mailing Address - Street 1:PO BOX 6035
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-8921
Mailing Address - Country:US
Mailing Address - Phone:808-480-1133
Mailing Address - Fax:
Practice Address - Street 1:18-2037 OHIA NANI RD
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:HI
Practice Address - Zip Code:96771
Practice Address - Country:US
Practice Address - Phone:808-480-1133
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-27
Last Update Date:2024-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty