Provider Demographics
NPI:1730877911
Name:MARUYA MAKEPEACE, MEGUMI (LMHC, PSYD)
Entity type:Individual
Prefix:DR
First Name:MEGUMI
Middle Name:
Last Name:MARUYA MAKEPEACE
Suffix:
Gender:F
Credentials:LMHC, PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1549 MOLEHU DR
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96818-1921
Mailing Address - Country:US
Mailing Address - Phone:808-782-0376
Mailing Address - Fax:
Practice Address - Street 1:1549 MOLEHU DR
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96818-1921
Practice Address - Country:US
Practice Address - Phone:808-782-0376
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-26
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMHC-943101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health