Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Johanna Park

Individual provider Counselor · NPI 1063853299

Johanna Park is a Mental Health Counselor in Hilo, Hawaii. Qualified in 2013, 13 years ago. Practices as a sole proprietor, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Hawaii.

Years since qualifying
13
Licensed in
HI
In the registry since
2013
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Practice location Address checks out

399 E Kawili St Ste 202
Hilo, HI 96720-5075
Phone: (808) 315-1432
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 74-381 Kealakehe Pkwy Ste G, Kailua Kona, HI 96740-2709 — (808) 315-1432

Specialties & licences

Counselor (primary) Taxonomy 101Y00000X · Licence MHC-427 (HI)

Record details

NPI number1063853299
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJuly 16, 2013
Last updated in NPPESMarch 25, 2020
Certification dateMarch 25, 2020
Mailing addressPo Box 6111, Kamuela, HI 96743-6111

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2013 (13 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

Other providers in Hilo