Individual provider Active NPI

Stephen Anthony Reynolds, PSYD

  • Clinical Psychologist
  • Kailua Kona, HI
National Provider Identifier
1679906614
Registry record updated Jul 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY-1750 Issued in HI
Practice address
75-5660 Kopiko St Ste C7
PMB 409
Kailua Kona, HI 96740-3122
Phone
(808) 207-5887
NPI assigned
Aug 13, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY-1750 HI Primary
Clinical Psychologist 103TC0700X 30232 CA

Addresses

Primary practice location

75-5660 Kopiko St Ste C7
PMB 409
Kailua Kona, HI 96740-3122

Mailing address

75-5660 Kopiko St Ste C7
PMB 409
Kailua Kona, HI 96740-3122
Phone (808) 207-5887

Other identifiers 1

IdentifierTypeStateIssuer
2886-3412OtherCAAMERICAN PSYCHOLOGICAL ASSOCIATION

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211228001375 HI Practitioner - Clinical Psychologist 6901297092 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Samaritan Counseling Center HawaiiGroup PAC ID 6507080918, 8 clinicians

Practice addresses (Care Compare)

1020 S Beretania St
Honolulu, HI 96814-1428
Phone (808) 545-2740

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY-1750HIMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Proactive Solutions LLC CurrentSince Jul 11, 2022 Accepting new patients
Samaritan Counseling Center Hawaii CurrentSince Dec 1, 2021 Accepting new patients

Locations

1020 S Beretania St
Honolulu, HI 96814
Phone (808) 545-2740

1050 Queen St
Ste 100
Honolulu, HI 96814
Phone (808) 207-5887

75-5660 Kopiko St
Ste C7
Kailua Kona, HI 96740

Organizations & group practices 2

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": "1376352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784678400000",
    "number": "1679906614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75-5660 KOPIKO ST STE C7",
            "address_2": "PMB 409",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967403122",
            "telephone_number": "808-207-5887",
            "fax_number": "808-240-2306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75-5660 KOPIKO ST STE C7",
            "address_2": "PMB 409",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967403122",
            "telephone_number": "808-207-5887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "STEPHEN",
        "middle_name": "ANTHONY",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-08-13",
        "last_updated": "2026-07-22",
        "certification_date": "2026-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "HI",
            "license": "PSY-1750",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "30232",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN PSYCHOLOGICAL ASSOCIATION",
            "identifier": "2886-3412",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kailua Kona, HI

Sources for this page

Verify at the official NPI Registry.