Diane Logan LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

DIANE LOGAN LLC

Practice address

75-5665 Kuakini Hwy Ste 2
Kailua Kona, HI 96740-1689

Phone

(808) 437-7447

Fax

(808) 374-9046

NPI assigned

Mar 20, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Diane Logan, PHD, ABPP, CSACNPI 1003207259

Title

Provider/Owner

Phone

(808) 437-7447

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in HI

Enrollment records 1

Locations

Practitioners 1

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

• Diane Logan, PHD, ABPP, CSAC

  • Clinical Psychologist
  • Kailua Kona, HI
  • NPI 1003207259
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1584662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783555200000",
    "number": "1265068233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5488",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967455488",
            "telephone_number": "808-437-7447",
            "fax_number": "808-374-9046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75-5665 KUAKINI HWY STE 2",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967401689",
            "telephone_number": "808-437-7447",
            "fax_number": "808-374-9046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIANE LOGAN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-20",
        "last_updated": "2026-07-09",
        "certification_date": "2026-07-09",
        "status": "A",
        "authorized_official_last_name": "LOGAN",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "PROVIDER/OWNER",
        "authorized_official_telephone_number": "808-437-7447",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD, ABPP, CSAC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Aimee A Disharoon, CPM, LM
• Walter Douglas Disney Jr., PHARM D

• Mental Health Clinic/Center (Including Community Mental Health Center) in Kailua Kona, HI
• Providers in Kailua Kona, HI by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2026; 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.