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Individual

MR. RAYMOND BLACK III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MA, BS, LMHC, CSAC

Contact information

Practice address
985 DILLINGHAM BLVD STE 100, HONOLULU, HI 96817-5772
(808) 834-2823
Mailing address
985 DILLINGHAM BLVD STE 100, HONOLULU, HI 96817-5772
(808) 392-3605

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
HI
101YA0400X
Addiction (Substance Use Disorder) Counselor
1564-10
HI
101YM0800X
Mental Health Counselor
MHC-636
HI
101YP1600X
Pastoral Counselor
Primary
2009-835
HI

Other

Enumeration date
09/18/2019
Last updated
09/24/2019
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