Basic Information
Provider Information
NPI: 1548612120
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BIXEL
FirstName: MEGAN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: BA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 615 PIIKOI ST STE 203
Address2:  
City: HONOLULU
State: HI
PostalCode: 968143139
CountryCode: US
TelephoneNumber: 8085891829
FaxNumber:  
Practice Location
Address1: 615 PIIKOI ST STE 203
Address2:  
City: HONOLULU
State: HI
PostalCode: 968143139
CountryCode: US
TelephoneNumber: 8085891829
FaxNumber: 8085892610
Other Information
ProviderEnumerationDate: 07/07/2016
LastUpdateDate: 07/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800X  N Behavioral Health & Social Service ProvidersCounselorMental Health
101YM0800X HIY Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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