Hawaii Depression Clinic

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

HAWAII DEPRESSION CLINIC

Practice address

99-128 Aiea Heights Dr Ste 109
Aiea, HI 96701-3916

Phone

(808) 492-1621

NPI assigned

Nov 1, 2021

Organization subpart

No

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

Authorized official

Name

David Simonsen, LMFT

Title

Co-Owner

Phone

(808) 492-1621

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in HI

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Brendon Michael Friedman, DNP, MBA, APRN-RX

  • Family Nurse Practitioner
  • Honolulu, HI
  • NPI 1073055752
  Medicare reassignment NPD
• Erik Jul, PSYD

  • Clinical Psychologist
  • Honolulu, HI
  • NPI 1417253287
  Medicare reassignment NPD
• John Neuhaus, M.D.

  • Psychiatry Physician
  • Honolulu, HI
  • NPI 1700085321
  Medicare reassignment NPD
• Brandon J McNichols, PSYD

  • Clinical Psychologist
  • Aiea, HI
  • NPI 1659816684
  NPD (past)

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

{
    "created_epoch": "1635724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668038400000",
    "number": "1184389587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99-128 AIEA HEIGHTS DR STE 109",
            "city": "AIEA",
            "state": "HI",
            "postal_code": "967013916",
            "telephone_number": "808-492-1621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99-128 AIEA HEIGHTS DR STE 109",
            "city": "AIEA",
            "state": "HI",
            "postal_code": "967013916",
            "telephone_number": "808-492-1621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAWAII DEPRESSION CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-01",
        "last_updated": "2022-11-10",
        "certification_date": "2022-11-10",
        "status": "A",
        "authorized_official_last_name": "SIMONSEN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "808-492-1621",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lloyd S Hataishi, DDS
• Olivia Hautamaa, DDS
• Hawai'I DCR Healthcare Division
• Hawaii Asthma Allergy Associates Inc
• Hawaii Dental Group, Inc.
• Hawaii Dermatology & Surgery, Inc
• Hawaii Foot & Ankle Associates LLC
• Hawaii Gastroenterology Specialist
• Hawaii Home Health Care, Inc.
• Hawaii Homecare Medical Supply

• Psychiatry Physician in Aiea, HI
• Providers in Aiea, HI by specialty
• Psychiatry Physician in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.