Active NPI
Alexander Limjoco Mangindin, LICSW
- Clinical Social Worker
- Honolulu, HI
National Provider Identifier
1699080168
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LC303584
- Practice address
- 1 Jarrett White Road Tamc
Honolulu, HI 96819-5000 - Phone
- (808) 433-6661
- NPI assigned
- Aug 9, 2010
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LC303584 | DC | Primary |
| Clinical Social Worker | 1041C0700X | 4308 | TN |
Addresses
Primary practice location
1 Jarrett White Road Tamc
Honolulu, HI 96819-5000
Mailing address
450 Hinano Way
Unit 1
Kailua, HI 96734-5547
Phone (719) 337-4941
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1 | Other | HI | MEDDAC |
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 |
|---|---|---|---|
| LC303584 | DC | MD | Clinical Social Worker |
| 4308 | TN | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1281312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1281312000000",
"number": "1699080168",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "450 HINANO WAY",
"address_2": "UNIT 1",
"city": "KAILUA",
"state": "HI",
"postal_code": "967345547",
"telephone_number": "719-337-4941"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 JARRETT WHITE ROAD TAMC",
"city": "HONOLULU",
"state": "HI",
"postal_code": "968195000",
"telephone_number": "808-433-6661"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANGINDIN",
"first_name": "ALEXANDER",
"middle_name": "LIMJOCO",
"name_prefix": "Mr.",
"credential": "LICSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-08-09",
"last_updated": "2010-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "DC",
"license": "LC303584",
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TN",
"license": "4308",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDDAC",
"identifier": "1",
"state": "HI"
}
],
"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 Aug 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.