Kelly H Takasawa, PSYD LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY-1215 Issued in HI

Legal business name

KELLY H TAKASAWA, PSYD LLC

Practice address

1221 Kapiolani Blvd Ste 211
Honolulu, HI 96814-3506

Phone

(808) 538-7793

NPI assigned

Jan 15, 2018

Organization subpart

No

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

Authorized official

Name

Kelly Takasawa, PSYDNPI 1508166877

Title

Clinical Psychologist

Phone

(808) 538-7793

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in HI

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kelly H. Takasawa, PSY.D.

  • Clinical Psychologist
  • Honolulu, HI
  • NPI 1508166877
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1515974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1515974400000",
    "number": "1871001636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 KAPIOLANI BLVD STE 211",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968143506",
            "telephone_number": "808-538-7793",
            "fax_number": "808-538-7799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 KAPIOLANI BLVD STE 211",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968143506",
            "telephone_number": "808-538-7793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLY H TAKASAWA, PSYD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-15",
        "last_updated": "2018-01-15",
        "status": "A",
        "authorized_official_last_name": "TAKASAWA",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "808-538-7793",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "HI",
            "license": "PSY-1215",
            "primary": true
        },
        {
            "code": "103TH0004X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Health",
            "state": "HI",
            "license": "PSY-1215",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kellie Kurasaki, MD, LLC
• Kellie Wo MD LLC
• Bart M Kellner, PT, CMPT, CSCS
• Gina R. Kellner, M.D.
• Timothy Kellner, MD
• Kelly Hee Therapy LLC
• Ava Kelly, RBT
• Lili Kelly, MD
• Melanie KTH Kelly, M.D.
• Kelsey Fujinaka PSYD

• Clinical Psychologist in Honolulu, HI
• Providers in Honolulu, HI by specialty
• Clinical Psychologist in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.