# ISLAND THERAPEUTIC SPECIALISTS LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407283732
- **Authorized official:** TERESA CRUZAN MS CCC-SLP (CEO/DIRECTOR OF THERAPEUTIC SERVICE)
- **Authorized official phone:** (808) 238-9565

## Contact information

- **Practice address:** 81-6587 MAMALAHOA HWY, SUITE C-203, KEALAKEKUA, HI 96750
- **Practice address phone:** (808) 987-2451
- **Mailing address:** PO BOX 928, CAPTAIN COOK, HI 96704-0928
- **Mailing address phone:** (808) 987-2451

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | 1535-10 | HI | — |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | 1663-12 | HI | — |
| 1041C0700X | Clinical Social Worker | 3904 | HI | — |
| 235Z00000X | Speech-Language Pathologist | 1055 | HI | Yes |
| 235Z00000X | Speech-Language Pathologist | 1286 | HI | — |

## Other

- **Enumeration date:** 10/01/2013
- **Last updated:** 05/05/2014