Organization
KOKUA SUPPORT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRISTYN HAXTON MSCP,CSAC, SAP (PRESIDENT)
(808) 847-5777
Entity
Organization
Contact information
Practice address
1803 N KING ST, HONOLULU, HI 96819-3451
(808) 847-4227
(808) 842-0044
Mailing address
PO BOX 17870, HONOLULU, HI 96817-0870
(808) 847-4227
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
10694948
HI
101YA0400X
Addiction (Substance Use Disorder) Counselor
10694948
HI
101YM0800X
Mental Health Counselor
10694948
HI
101YP1600X
Pastoral Counselor
10694948
HI
101YP2500X
Professional Counselor
10694948
HI
103K00000X
Behavior Analyst
10694948
HI
251S00000X
Community/Behavioral Health Agency
10694948
HI
252Y00000X
Early Intervention Provider Agency
10694948
HI
Other
Enumeration date
08/26/2014
Last updated
10/02/2014
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