Lisa Christine Cavanagh, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY-1573 Issued in HI

Practice address

6099 Heron Ave
Ewa Beach, HI 96706-3367

Phone

(612) 578-4148

NPI assigned

Mar 7, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Hale Kipa, Inc.

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Ewa Beach, HI
  • NPI 1164627246
  NPD (past)

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

{
    "created_epoch": "1394150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570147200000",
    "number": "1710303318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6099 HERON AVE",
            "city": "EWA BEACH",
            "state": "HI",
            "postal_code": "967063367",
            "telephone_number": "612-578-4148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6099 HERON AVE",
            "city": "EWA BEACH",
            "state": "HI",
            "postal_code": "967063367",
            "telephone_number": "612-578-4148"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4800 Memorial Dr",
            "address_2": "Bldg 94",
            "address_purpose": "LOCATION",
            "city": "Waco",
            "state": "TX",
            "postal_code": "767111329",
            "country_code": "US",
            "telephone_number": "254-297-3545",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "615 Piikoi St Ste 203",
            "address_purpose": "LOCATION",
            "city": "Honolulu",
            "state": "HI",
            "postal_code": "968143139",
            "country_code": "US",
            "telephone_number": "808-589-1829 x114",
            "fax_number": "808-589-2610",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAVANAGH",
        "first_name": "LISA",
        "middle_name": "CHRISTINE",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-07",
        "last_updated": "2019-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "HI",
            "license": "PSY-1573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marivyn Aurelio Casino, C.N.A
• Kathleen Castillo, MFT
• Winalle Rose Castillo
• Persephone Castro
• Alice Caudill
• Thea Ann Cayaban de Vero, PT/PTA
• Center for Allergy and Respiratory Diseases Inc. (Card Inc.)
• Vanessa Dulay Cerezo
• David Sung Geun Cha, MD
• Jacqueline Yvonne Chacon, ANP

• Clinical Psychologist in Ewa Beach, HI
• Providers in Ewa Beach, HI by specialty
• Clinical Psychologist in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2019; 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.