Organization Active NPI

Bearden Psychological Services LLC

  • Adult Mental Health Clinic/Center
  • Hilo, HI
National Provider Identifier
1649464355
Registry record updated Dec 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
License
PSY 888 Issued in HI
Legal business name
BEARDEN PSYCHOLOGICAL SERVICES LLC
Practice address
101 Aupuni St
Suite 1014 a-2
Hilo, HI 96720-4246
Phone
(808) 935-2605
Fax
(808) 935-2650
NPI assigned
Sep 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2011

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

Authorized official

Name
Dr. Thomas Stennis Bearden, PH.D.
Title
President
Phone
(808) 935-2605

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X PSY 888 HI Primary
Adolescent and Children Mental Health Clinic/Center 261QM0855X PSY 888 HI

Addresses

Primary practice location

101 Aupuni St
Suite 1014 a-2
Hilo, HI 96720-4246

Mailing address

101 Aupuni St
Suite 1014 a-2
Hilo, HI 96720-4246
Phone (808) 935-2605

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1189036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323648000000",
    "number": "1649464355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 AUPUNI ST",
            "address_2": "SUITE 1014 A-2",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967204246",
            "telephone_number": "808-935-2605",
            "fax_number": "808-935-2650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 AUPUNI ST",
            "address_2": "SUITE 1014 A-2",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967204246",
            "telephone_number": "808-935-2605",
            "fax_number": "808-935-2650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEARDEN PSYCHOLOGICAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-06",
        "last_updated": "2011-12-12",
        "status": "A",
        "authorized_official_last_name": "BEARDEN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "STENNIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "808-935-2605",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "HI",
            "license": "PSY 888",
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "HI",
            "license": "PSY 888",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hilo, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.