Provider Demographics
NPI:1366205155
Name:KAKOU BEHAVIORAL THERAPY, LLC
Entity type:Organization
Organization Name:KAKOU BEHAVIORAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MAKENA
Authorized Official - Middle Name:MJ
Authorized Official - Last Name:LAU
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:808-224-4102
Mailing Address - Street 1:987 QUEEN ST APT 513
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-5264
Mailing Address - Country:US
Mailing Address - Phone:808-224-4102
Mailing Address - Fax:
Practice Address - Street 1:987 QUEEN ST APT 513
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-5264
Practice Address - Country:US
Practice Address - Phone:808-224-4102
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty