Individual provider Active NPI

Neil O Annandale, PH.D., CGP

  • Counseling Psychologist
  • Hauula, HI
National Provider Identifier
1770046674
Registry record updated Apr 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
1202 Issued in HI
Practice address
54-242B Honomu Street
Hauula, HI 96717
Phone
(808) 429-5504
NPI assigned
Apr 9, 2019
Last updated
Apr 9, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X 1202 HI Primary

Addresses

Primary practice location

54-242B Honomu Street
Hauula, HI 96717

Mailing address

P.O. Box 804
Hauula, HI 96717
Phone (808) 429-5504

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
I20190607001351 HI Practitioner - Clinical Psychologist 0244563120 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1202HIMDCounseling Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Val J Umphress PHD LLC CurrentSince Mar 30, 2019 Accepting new patients

Locations

99-128 Aiea Heights Dr
Ste 305
Aiea, HI 96701
Phone (808) 488-9288

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1554768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554768000000",
    "number": "1770046674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 804",
            "city": "HAUULA",
            "state": "HI",
            "postal_code": "96717",
            "telephone_number": "808-429-5504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54-242B HONOMU STREET",
            "city": "HAUULA",
            "state": "HI",
            "postal_code": "96717",
            "telephone_number": "808-429-5504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANNANDALE",
        "first_name": "NEIL",
        "middle_name": "O",
        "credential": "PH.D., CGP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-09",
        "last_updated": "2019-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "HI",
            "license": "1202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hauula, HI

Sources for this page

Verify at the official NPI Registry.