Basic Information
Provider Information
NPI: 1528701273
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LAWRENCE
FirstName: SHAILA
MiddleName: HOKULANI APELE
NamePrefix:  
NameSuffix:  
Credential: MA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 622 HINANO ST
Address2:  
City: HILO
State: HI
PostalCode: 967204427
CountryCode: US
TelephoneNumber: 8088967793
FaxNumber:  
Practice Location
Address1: 622 HINANO ST
Address2:  
City: HILO
State: HI
PostalCode: 967204427
CountryCode: US
TelephoneNumber: 8085891829
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/19/2022
LastUpdateDate: 06/01/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/01/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800X  Y Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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