DR. JENNIFER L. DE COSTA (NPI# 1063665529) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1063665529 |
Entity Type | Individual |
Full Name | DR. JENNIFER L. DE COSTA |
Credential | PHD, MFT, CSAC |
Practice Address |
75-5751 Kuakini Hwy Suite 105 Kailua Kona HI 96740-1752 |
Practice Telephone | 8083265629 |
Practice Fax Number | 8083295057 |
Mailing Telephone | 8083265629 |
Mailing Fax Number | 8083295057 |
Enumeration Date | 2008-10-28 |
Last Update Date | 2011-04-06 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
1249-05 | HI | Behavioral Health & Social Service Providers |
Y | 106H00000X | Marriage & Family Therapist | MFT272 | HI | Behavioral Health & Social Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
HI | MFT | MFT272 | 01 |
HI | CSAC | 1249-05 | 01 |
Street Address |
75-5751 KUAKINI HWY SUITE 105 |
City | KAILUA KONA |
State | HI |
Zip Code | 96740-1752 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1033118971 | David Marvin Woodliff | Family Medicine | 75-5751 Kuakini Hwy, Ste 203, Kailua Kona, HI 96740-1752 | 2005-07-21 |
1013514868 | Melissa John Manasas | Social Worker | 75-5751 Kuakini Hwy, Kailua Kona, HI 96740-1752 | 2020-10-05 |
1285187773 | Katherine Knezek May | Psychologist | 75-5751 Kuakini Hwy, Suite #104, Kailua Kona, HI 96740-1752 | 2016-08-01 |
1780036517 | Ibid M Nicolaisen | Nurse Practitioner | 75-5751 Kuakini Hwy, Ste 203, Kailua Kona, HI 96740-1752 | 2016-07-05 |
1912391764 | Steven Nishimoto | Pharmacist | 75-5751 Kuakini Hwy, Ste #104, Kailua Kona, HI 96740-1752 | 2015-03-18 |
1669802310 | Erin G Beasley | Nurse Practitioner | 75-5751 Kuakini Hwy, Ste 203, Kailua Kona, HI 96740-1753 | 2013-11-16 |
1033463948 | Robert Peter Edmonds | Family Medicine | 75-5751 Kuakini Hwy, Suite 101, Kailua Kona, HI 96740-1752 | 2012-10-30 |
1841566064 | Shannon Price | Family Medicine | 75-5751 Kuakini Hwy, Ste 203, Kailua Kona, HI 96740-1752 | 2012-04-02 |
1821386095 | Anjalie Rose Graham | Nurse Practitioner | 75-5751 Kuakini Hwy, Kailua Kona, HI 96740-1752 | 2011-07-21 |
1609162981 | Cindy A Jean-rooney | Nurse Practitioner | 75-5751 Kuakini Hwy, Suite 203, Kailua Kona, HI 96740-1752 | 2011-06-24 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1649870577 | Elise Christine Duvua | Massage Therapist | 75-127 Lunadule Rd. Suite #5, Kailua Kona, HI 96740 | 2020-10-29 |
1356954820 | Zellda Keath | Acupuncturist | Kohanaiki Club Services, 73-2055 Ala Kohanaiki, Kailua-kona, HI 96740 | 2020-08-25 |
1467070979 | Safeway Inc | Durable Medical Equipment & Medical Supplies | 75-971 Henry St, Kailua Kona, HI 96740 | 2020-07-10 |
1275182040 | Jessica Marie Penaranda | Pharmacist | 5595 Palani Road, Kona, HI 96740 | 2019-09-05 |
1558870600 | Malia Lewis Vannatta | Nurse Practitioner | 75-184 Hulalalai Rd, 302, Kailua Kona, HI 96740 | 2017-09-20 |
1043759087 | Paul Michael Heller | Acupuncturist | 72 3996 Hawaii Belt Rd, Kailua Kona, HI 96740 | 2017-02-22 |
1255787974 | John Fujita | Pharmacist | 74-5456 Kamakaeha Ave, Kailua Kona, HI 96740 | 2016-05-11 |
1326425083 | Lauren Deweese | Massage Therapist | 76-6194 Holualoa Beach Rd, Unit 6, Kailua-kona, HI 96740 | 2015-05-01 |
1073907754 | Kathleen Marie Coyle | Massage Therapist | 76-217 Keakealani Street, Kailua Kona, HI 96740 | 2015-03-20 |
1841609971 | Shellie R Norman | Nurse Practitioner | 75-5995 Kuakini Hwy Ste 443&445, Kailua Kona, HI 96740 | 2014-08-01 |
Find all providers in zip 96740 |
Taxonomy Code | 106H00000X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Marriage & Family Therapist |
A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1619520590 | Natasha Mccool | Marriage & Family Therapist | 74-5555 Kaiwi St Unit F4, Kailua Kona, HI 96740-3193 | 2019-07-19 |
1679066732 | Stephanie Grace Daniels | Marriage & Family Therapist | 73-4530 Mamalahoa Hwy, Kailua Kona, HI 96740-9198 | 2018-06-12 |
1407375140 | Jeff Mcbride, Lmft | Marriage & Family Therapist | 74-381 Kealakehe Pkwy Ste F, Kailua Kona, HI 96740-2709 | 2017-09-13 |
1114272002 | Sundara Amber Lotus Fitz-gerald | Marriage & Family Therapist | 75-5744 Alii Dr Ste 237, Kailua Kona, HI 96740-1740 | 2012-07-17 |
1437381332 | Maite E. Anasagasti Robles | Marriage & Family Therapist | 73-4316 Iliili St, Kailua Kona, HI 96740-9504 | 2009-08-11 |
1972778546 | Madeleine Cash Ferguson | Marriage & Family Therapist | 73-4328 Keokeo St, Kailua Kona, HI 96740-8540 | 2008-04-24 |
1225201080 | Shelley Shane | Marriage & Family Therapist | 74-381 Kealakehe Pkwy, Suite I & J, Kailua Kona, HI 96740-2705 | 2008-04-11 |
1245402395 | Karl Prater | Marriage & Family Therapist | 73-1115 Ahikawa St, Kailua Kona, HI 96740-9410 | 2008-03-28 |
1912117953 | Jan Fradenburg | Marriage & Family Therapist | 74-5622 Alapa St, Suite 202, Kailua Kona, HI 96740-3108 | 2007-05-22 |
1295944304 | Linda Purcell Satchell | Marriage & Family Therapist | 75-127 Lunapule Rd Ste 4a, Kailua Kona, HI 96740-2119 | 2007-05-22 |
Find all providers in KAILUA KONA |
City | KAILUA KONA |
Zip Code | 96740 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.