Active NPI
Taliesin Sumner-Longboy, MSW
- Social Worker
- Pahoa, HI
National Provider Identifier
1013434505
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- Practice address
- RR 3 Box 81766
Pahoa, HI 96778-0284 - Phone
- (808) 481-7283
- NPI assigned
- Aug 24, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | Primary |
Addresses
Primary practice location
RR 3 Box 81766
Pahoa, HI 96778-0284
Mailing address
RR 3 Box 81766
Pahoa, HI 96778-0284
Phone (808) 481-7283
Other practice location 1
80 Pauahi St Ste 101
Hilo, HI 96720-3043
Phone (808) 481-7283
Other practice location 2
80 Pauahi St Ste 208 & 209
Hilo, HI 96720-3065
Phone (808) 969-1935
Other names 1
- Taliesin Sumner
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Therapy Space LLC | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Pahoa, HI
- NPI 1679329486
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1503532800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1716336000000",
"number": "1013434505",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "RR 3 BOX 81766",
"city": "PAHOA",
"state": "HI",
"postal_code": "967780284",
"telephone_number": "808-481-7283"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "RR 3 BOX 81766",
"city": "PAHOA",
"state": "HI",
"postal_code": "967780284",
"telephone_number": "808-481-7283"
}
],
"practiceLocations": [
{
"address_1": "80 Pauahi St Ste 101",
"address_purpose": "LOCATION",
"city": "Hilo",
"state": "HI",
"postal_code": "967203043",
"country_code": "US",
"telephone_number": "808-481-7283",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "80 Pauahi St Ste 208 & 209",
"address_purpose": "LOCATION",
"city": "Hilo",
"state": "HI",
"postal_code": "967203065",
"country_code": "US",
"telephone_number": "808-969-1935",
"fax_number": "808-969-3276",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SUMNER-LONGBOY",
"first_name": "TALIESIN",
"credential": "MSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-08-24",
"last_updated": "2024-05-22",
"certification_date": "2024-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "TALIESIN",
"last_name": "SUMNER",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Pahoa, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.