Individual provider Active NPI

Tiffany C Lee, PSY.D.

  • Clinical Psychologist
  • Kaneohe, HI
National Provider Identifier
1093062648
Registry record updated Nov 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY-1379 Issued in HI
Practice address
46-170 Ohala St
Kaneohe, HI 96744-4060
Phone
(808) 888-9046
NPI assigned
Aug 13, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY.0005572 CO
Clinical Psychologist 103TC0700X PSY-1379 HI Primary

Addresses

Primary practice location

46-170 Ohala St
Kaneohe, HI 96744-4060

Mailing address

536 Tamarack Dr Unit 401
Steamboat Springs, CO 80487-3152
Phone (808) 888-9046

Other practice location 1

536 Tamarack Dr Unit 401
Steamboat Springs, CO 80487-3152
Phone (808) 888-9046

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130611000843 HI Practitioner - Clinical Psychologist 0042459661 Practice locations: Kaneohe, HI

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY.0005572COMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Hawaii Psychological Services, Inc Clinical CurrentSince Jun 1, 2013 Accepting new patients
Tiffany C. Lee, Psy.D. LLC Clinical CurrentSince Nov 12, 2023 Accepting new patients
Islands Hospice, Inc. PastSince Jun 1, 2013 Accepting new patients

Locations

98-084 Kamehameha Hwy
Ste 301A
Aiea, HI 96701
Phone (808) 282-9046

1001 Kamokila Blvd
Ste 262
Kapolei, HI 96707
Phone (808) 484-1122

Networks

  • HI PPO
  • devoted network organization-c89d4c14-e90f-4cf7-83f9-456527a52335

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1344816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699488000000",
    "number": "1093062648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "536 TAMARACK DR UNIT 401",
            "city": "STEAMBOAT SPRINGS",
            "state": "CO",
            "postal_code": "804873152",
            "telephone_number": "808-888-9046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46-170 OHALA ST",
            "city": "KANEOHE",
            "state": "HI",
            "postal_code": "967444060",
            "telephone_number": "808-888-9046"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "536 Tamarack Dr Unit 401",
            "address_purpose": "LOCATION",
            "city": "Steamboat Springs",
            "state": "CO",
            "postal_code": "804873152",
            "country_code": "US",
            "telephone_number": "808-888-9046",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "TIFFANY",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-13",
        "last_updated": "2023-11-09",
        "certification_date": "2023-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "PSY.0005572",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "HI",
            "license": "PSY-1379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kaneohe, HI

Sources for this page

Verify at the official NPI Registry.