1942529789 NPI number — MS. ELIZABETH M KONG LMFT

Table of content: MS. ELIZABETH M KONG LMFT (NPI 1942529789)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942529789 NPI number — MS. ELIZABETH M KONG LMFT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KONG
Provider First Name:
ELIZABETH
Provider Middle Name:
M
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LMFT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1942529789
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/29/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
850 RICHARDS ST STE 600
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HONOLULU
Provider Business Mailing Address State Name:
HI
Provider Business Mailing Address Postal Code:
96813-4713
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
808-722-7045
Provider Business Mailing Address Fax Number:
808-892-3683

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
850 RICHARDS ST STE 600
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96813-4713
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-722-7045
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/19/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X , with the licence number:  MFT 238 , registered in the state of HI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0000294363 . This is a "HMSA" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: 272605113 . This is a "HAWAII MEDICAL ASSURANCE ASSOCIATION (HMAA)" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: 272605113 . This is a "UHA HEALTH INSURANCE" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: 99726 . This is a "TRICARE WEST" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: 272605113 . This is a "NEW HORIZONS BEHAVIORAL HEALTH" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 272605113 . This is a "HAWAII WESTERN MEDICAL GROUP (MWMG)" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: 737067 , issued by the state of ( HI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000678397001 . This is a "OPTUM BEHAVIOR HEALTH" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: 4608703 . This is a "AMERICAN FOREIGN BENEFIT" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".




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