Johanna Park
NPI 1063853299ActiveIndividual· Counselor· Hilo, HI
Counselor in Hilo, Hawaii, licensed in HI, with an NPI issued in July 2013. Enrolled in Medicare as practitioner - mental health counselor.
Overview
| NPI | 1063853299 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | Yes |
| NPI issued | Jul 16, 2013 |
| Last updated in NPPES | Mar 25, 2020 |
| Certified by provider | Mar 25, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Counselor Primary | 101Y00000X | MHC-427 | HI |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Mental Health Counselor (HI) |
|---|
Education and affiliations
| Graduation year | 2013 |
|---|---|
| Medicare specialty | Mental Health Counselor |
| Telehealth | Offers telehealth |
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