North Shore Collaborative Therapy
Organization Active NPI Clinical Psychologist · Waialua, HI
NPI 1194367979 · NPPES record last updated Oct 16, 2023
Key facts
- NPI
- 1194367979
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinical Psychologist 103TC0700X
- Legal business name
- NORTH SHORE COLLABORATIVE THERAPY
- Practice address
- 66-892 Wanini St
Waialua, HI 96791-9758 - Phone
- (808) 457-1311
- Fax
- (808) 457-1311
- NPI assigned
- Oct 12, 2019
- Organization subpart
- No
Authorized official
- Name
- June Hurst-Jones, PSYD
- Title
- Owner
- Phone
- (808) 457-1311
Practitioners 1
-
June Hurst-Jones, PSY, MFT
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in HI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20231107000386 | HI | Part B Supplier - Clinic/Group Practice | 3476900853 |
Receives reassigned benefits from 1 practitioner Practice locations: Waialua, HI |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist |
103TC0700X | Yes |
Addresses
Primary practice location
66-892 Wanini St
Waialua, HI 96791-9758
Mailing address
66-892 Wanini St
Waialua, HI 96791-9758
Phone (808) 457-1311
Other providers in Waialua, HI
- Elise Marie Louro
- Tammy M McKee
- Joel Medinger
- Etsuko Morikawa
- Nancy K L Delamarter
- North Shore Health and Wellness, LLC
- Tiffani Sakiko Mahina Obayashi
- Nicole M Oishi
- Tzaddi Lee Pearce
- Reliable Transportation LLC
All providers in Waialua, HI · Clinical Psychologist in Hawaii
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 16, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.