Active NPI
Elizabeth Everett, CSAC
- Clinical Psychologist
- Honolulu, HI
National Provider Identifier
1194240549
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY2068
- Practice address
- 3627 Kilauea Ave
Honolulu, HI 96816-2317 - Phone
- (808) 733-9357
- NPI assigned
- Aug 7, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 1917-16 | HI | |
| Clinical Psychologist | 103TC0700X | PSY2068 | HI | Primary |
Addresses
Primary practice location
3627 Kilauea Ave
Honolulu, HI 96816-2317
Mailing address
3627 Kilauea Ave
Honolulu, HI 96816-2317
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Mar 8, 2024 through Mar 8, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1917-16 | HI | MD | Addiction (Substance Use Disorder) Counselor |
| PSY2068 | HI | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1502064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678838400000",
"number": "1194240549",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3627 KILAUEA AVE",
"city": "HONOLULU",
"state": "HI",
"postal_code": "968162317"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3627 KILAUEA AVE",
"city": "HONOLULU",
"state": "HI",
"postal_code": "968162317",
"telephone_number": "808-733-9357"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVERETT",
"first_name": "ELIZABETH",
"credential": "CSAC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-08-07",
"last_updated": "2023-03-15",
"certification_date": "2023-03-15",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "HI",
"license": "1917-16",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "HI",
"license": "PSY2068",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Honolulu, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.