Active NPI
Tracy Kelleher
- Behavior Analyst
- Honolulu, HI
National Provider Identifier
1669869913
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 210 Ward Ave
Suite 219B
Honolulu, HI 96814-4008 - Phone
- (808) 380-4465
- NPI assigned
- Apr 23, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | Primary |
Addresses
Primary practice location
210 Ward Ave
Suite 219B
Honolulu, HI 96814-4008
Mailing address
72-4109 Awalua PL
Kailua Kona, HI 96740-8444
Phone (305) 393-9805
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1429747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1429747200000",
"number": "1669869913",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "72-4109 AWALUA PL",
"city": "KAILUA KONA",
"state": "HI",
"postal_code": "967408444",
"telephone_number": "305-393-9805"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "210 WARD AVE",
"address_2": "SUITE 219B",
"city": "HONOLULU",
"state": "HI",
"postal_code": "968144008",
"telephone_number": "808-380-4465"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLEHER",
"first_name": "TRACY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-04-23",
"last_updated": "2015-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"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 Apr 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.