Angela Carlson Broff, MSCP

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

BA-24 Issued in HI

Practice address

111 Hekili St Ste a
#406
Kailua, HI 96734

Phone

(808) 489-3548

Fax

(808) 443-0708

NPI assigned

Oct 14, 2008

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Angela Carlson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Windward Synergy Center

  • Community/Behavioral Health Agency
  • Kailua, HI
  • NPI 1982078846
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1223942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1073765764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 HEKILI ST STE A406",
            "city": "KAILUA",
            "state": "HI",
            "postal_code": "967342800",
            "telephone_number": "808-489-3548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 HEKILI ST STE A",
            "address_2": "#406",
            "city": "KAILUA",
            "state": "HI",
            "postal_code": "96734",
            "telephone_number": "808-489-3548",
            "fax_number": "808-443-0708"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "615 Piikoi St",
            "address_2": "Suite 105",
            "address_purpose": "LOCATION",
            "city": "Honolulu",
            "state": "HI",
            "postal_code": "968143116",
            "country_code": "US",
            "telephone_number": "808-375-7248",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "615 Piikoi St",
            "address_2": "Suite 105",
            "address_purpose": "LOCATION",
            "city": "Honolulu",
            "state": "HI",
            "postal_code": "968143116",
            "country_code": "US",
            "telephone_number": "808-375-7248",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARLSON BROFF",
        "first_name": "ANGELA",
        "credential": "MSCP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-14",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "HI",
            "license": "BA-24",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "CARLSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sarah Canyon, MD PHD
• Cardiothoracic Associates of Hawaii LLC
• Caremark LLC (Caremark)
• Caremark, L.L.C. (Caremark Hawaii Specialty Pharmacy, LLC dba CVS Caremark)
• Gloria N Carlile
• Jonathan David Carlson, M.D.
• Alexandria Carlyle, DMD
• Carmenne Chiasson PHD Inc (Carmenne Chiasson, PhD)
• Caroline Ritson, MD LLC (Mind in Tune)
• Pamela Carr, RN

• Behavior Analyst in Kailua, HI
• Providers in Kailua, HI by specialty
• Behavior Analyst in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.