Active NPI
Tamara L Michaelson, MSW, CSAC, LCSW
- Clinical Social Worker
- Honolulu, HI
National Provider Identifier
1568041275
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCSW-4966
- Practice address
- 500 Ala Moana Blvd Ste 7400
Honolulu, HI 96813-4902 - Phone
- (415) 424-4266
- Fax
- (415) 520-6633
- NPI assigned
- Apr 8, 2021
- 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 | 3018-21 | HI | |
| Clinical Social Worker | 1041C0700X | LCSW-4966 | HI | Primary |
Addresses
Primary practice location
500 Ala Moana Blvd Ste 7400
Honolulu, HI 96813-4902
Mailing address
PO Box 135
Maunaloa, HI 96770-0135
Phone (808) 658-1274
Other practice location 1
1188 Bishop St Ste 2212
Honolulu, HI 96813-3309
Phone (562) 296-2730
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3018-21 | HI | MD | Addiction (Substance Use Disorder) Counselor |
| LCSW-4966 | HI | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Telehealth Services USA | Clinical | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1617840000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1732060800000",
"number": "1568041275",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 135",
"city": "MAUNALOA",
"state": "HI",
"postal_code": "967700135",
"telephone_number": "808-658-1274"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 ALA MOANA BLVD STE 7400",
"city": "HONOLULU",
"state": "HI",
"postal_code": "968134902",
"telephone_number": "415-424-4266",
"fax_number": "415-520-6633"
}
],
"practiceLocations": [
{
"address_1": "1188 Bishop St Ste 2212",
"address_purpose": "LOCATION",
"city": "Honolulu",
"state": "HI",
"postal_code": "968133309",
"country_code": "US",
"telephone_number": "562-296-2730",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MICHAELSON",
"first_name": "TAMARA",
"middle_name": "L",
"name_prefix": "Miss",
"credential": "MSW, CSAC, LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-04-08",
"last_updated": "2024-11-20",
"certification_date": "2024-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "HI",
"license": "3018-21",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "HI",
"license": "LCSW-4966",
"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 Nov 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.