Individual provider Active NPI

Alexander Limjoco Mangindin, LICSW

  • Clinical Social Worker
  • Honolulu, HI
National Provider Identifier
1699080168
Registry record updated Aug 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC303584 Issued in DC
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

Updated by the provider on Aug 9, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
1OtherHIMEDDAC

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

LicenseStateTypeSpecialty
LC303584DCMDClinical Social Worker
4308TNMDSpeech-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.

Verify at the official NPI Registry.