Provider Demographics
NPI:1861212128
Name:CHOICEPOINT PSYCHOTHERAPY, LLC
Entity type:Organization
Organization Name:CHOICEPOINT PSYCHOTHERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:RUTH
Authorized Official - Last Name:MARTINEZ-SUZUKAWA
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:808-215-7386
Mailing Address - Street 1:153 E. KAMEHAMEHA AVE.
Mailing Address - Street 2:SUITE 104, #163
Mailing Address - City:KAHULUI
Mailing Address - State:HI
Mailing Address - Zip Code:96732
Mailing Address - Country:US
Mailing Address - Phone:808-215-7386
Mailing Address - Fax:808-500-6997
Practice Address - Street 1:19 KAPALAIA PL
Practice Address - Street 2:
Practice Address - City:WAILUKU
Practice Address - State:HI
Practice Address - Zip Code:96793-2165
Practice Address - Country:US
Practice Address - Phone:808-215-7386
Practice Address - Fax:808-500-6997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-11
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty