Individual provider Active NPI

Jennifer O Cornwell, LMFT, CSAC,

  • Marriage & Family Therapist
  • Aiea, HI
National Provider Identifier
1154939874
Registry record updated Jul 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
384 Issued in HI
Practice address
98-820 Moanalua Rd # 15-526
Aiea, HI 96701-5200
Phone
(628) 227-0182
NPI assigned
Jul 20, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X 384 HI Primary

Addresses

Primary practice location

98-820 Moanalua Rd # 15-526
Aiea, HI 96701-5200

Mailing address

98-820 Moanalua Rd # 15-526
Aiea, HI 96701-5200
Phone (628) 227-0182

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

State licenses

LicenseStateTypeSpecialty
384HIMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1595203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595203200000",
    "number": "1154939874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "98-820 MOANALUA RD # 15-526",
            "city": "AIEA",
            "state": "HI",
            "postal_code": "967015200",
            "telephone_number": "628-227-0182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "98-820 MOANALUA RD # 15-526",
            "city": "AIEA",
            "state": "HI",
            "postal_code": "967015200",
            "telephone_number": "628-227-0182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNWELL",
        "first_name": "JENNIFER",
        "middle_name": "O",
        "name_prefix": "Mrs.",
        "credential": "LMFT, CSAC,",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-20",
        "last_updated": "2020-07-20",
        "certification_date": "2020-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "HI",
            "license": "384",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aiea, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2020; 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.