Hoomalie Psychiatry LLC
Organization Active NPI Psychiatric/Mental Health Nurse Practitioner · Lahaina, HI
NPI 1578348751 · NPPES record last updated Apr 11, 2024
Key facts
- NPI
- 1578348751
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- Legal business name
- HOOMALIE PSYCHIATRY LLC
- Practice address
- 673 Kaakolu St
Lahaina, HI 96761-1341 - Phone
- (808) 281-9342
- Fax
- (808) 481-0010
- NPI assigned
- Aug 28, 2023
- Organization subpart
- No
Authorized official
- Name
- Debra M Bates, NURSE PRACTITIONER
- Title
- Pmhnp
- Phone
- (808) 281-9342
Practitioners 1
-
Debra M Bates, PMHNP-BC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240514001199 | CO | Part B Supplier - Clinic/Group Practice | 9830530401 |
Receives reassigned benefits from 1 practitioner Practice locations: Windsor, CO |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner |
363LP0808X | Yes |
Addresses
Primary practice location
673 Kaakolu St
Lahaina, HI 96761-1341
Mailing address
PO Box 1154
Makawao, HI 96768-1154
Phone (808) 281-9342
Other practice location 1
951 Maplebrook Dr
Windsor, CO 80550-3924
Phone (808) 281-9611
Other providers in Lahaina, HI
- Amber Rose Hawkins
- Justin Hays
- Melissa L. Hessel
- Kammy Hodges
- Lisa M Hoogasian-Klein
- Heidi A. Howard
- Aubrey Huey
- Donna Ibuyan
- Sandra Lee Ignacio
- Dennis N Ishimoto
All providers in Lahaina, HI · Psychiatric/Mental Health Nurse Practitioner in Hawaii
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 11, 2024. 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.