Provider Demographics
NPI:1265163299
Name:PERSONAL GROWTH THERAPY LLC
Entity type:Organization
Organization Name:PERSONAL GROWTH THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:KAINA
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:808-371-3788
Mailing Address - Street 1:45-265 WILLIAM HENRY RD APT F12
Mailing Address - Street 2:
Mailing Address - City:KANEOHE
Mailing Address - State:HI
Mailing Address - Zip Code:96744-3175
Mailing Address - Country:US
Mailing Address - Phone:808-371-3788
Mailing Address - Fax:
Practice Address - Street 1:45-265 WILLIAM HENRY RD APT F12
Practice Address - Street 2:
Practice Address - City:KANEOHE
Practice Address - State:HI
Practice Address - Zip Code:96744-3175
Practice Address - Country:US
Practice Address - Phone:808-371-3788
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-21
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty