DR. JENNIFER L. DE COSTA


Address: 75-5751 Kuakini Hwy, Suite 105, Kailua Kona, HI 96740-1752
Phone: 8083265629

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).

Provider Overview

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

Taxonomy

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

Other Provider Identifier

State Issuer Identifier Type Code
HI MFT MFT272 01
HI CSAC 1249-05 01

Office Location

Street Address 75-5751 KUAKINI HWY
SUITE 105
City KAILUA KONA
State HI
Zip Code 96740-1752

Providers in the same location

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
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Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 106H00000X
Grouping Behavioral Health & Social Service Providers
Classification Marriage & Family Therapist

Taxonomy Definition

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.

Providers in the same taxonomy and city

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

Competitor

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City KAILUA KONA
Zip Code 96740

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Dataset Information

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.

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