De Costa, Jennifer L.

De Costa, Jennifer L. is an individual health care provider with primary practice located at 75-5751 Kuakini Hwy Suite 105, Kailua Kona HI 96740-1752. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Marriage & Family Therapist, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Behavioral Health & Social Service Providers / Marriage & Family Therapist is her primary health care specialty. De Costa, Jennifer L. can be contacted via phone (808) 326-5629.

Contact Information

Primary practice address
75-5751 Kuakini Hwy Suite 105 Kailua Kona HI 96740-1752
Phone: (808) 326-5629
Fax: (808) 329-5057
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X MFT272 Hawaii
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 1249-05 Hawaii

Profile Details

NPI number 1063665529
LBN Legal business name De Costa, Jennifer L.
Credentials PHD, MFT, CSAC
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 28th, 2008
Last updated Apr 6th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063665529 NPPES
Hawaii Other 1249-05 CSAC
Hawaii Other MFT272 CSAC

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