Organization Active NPI

Shanahan Family & Ind Psych Services Inc

  • Clinical Psychologist
  • Honolulu, HI
National Provider Identifier
1205016730
Registry record updated Dec 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY707 Issued in HI
Legal business name
SHANAHAN FAMILY & IND PSYCH SERVICES INC
Practice address
2347 Oahu Ave
Honolulu, HI 96822-1966
Phone
(808) 941-9307
NPI assigned
Nov 13, 2007
Last updated
Dec 5, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2007

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

Authorized official

Name
Dr. Roswitha ShanahanNPI 1548383433
Title
Clinical Psychologist
Phone
(808) 941-9307

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY707 HI Primary

Addresses

Primary practice location

2347 Oahu Ave
Honolulu, HI 96822-1966

Mailing address

2347 Oahu Ave
Honolulu, HI 96822-1966
Phone (808) 941-9307

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041013000423 HI Part B Supplier - Clinic/Group Practice 0446210603 Receives reassigned benefits from 1 practitioner
Practice locations: Honolulu, HI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1194912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196812800000",
    "number": "1205016730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2347 OAHU AVE",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968221966",
            "telephone_number": "808-941-9307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2347 OAHU AVE",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968221966",
            "telephone_number": "808-941-9307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHANAHAN FAMILY & IND PSYCH SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-13",
        "last_updated": "2007-12-05",
        "status": "A",
        "authorized_official_last_name": "SHANAHAN",
        "authorized_official_first_name": "ROSWITHA",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "808-941-9307",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "HI",
            "license": "PSY707",
            "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 Dec 5, 2007; 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.