Stacy Haunani Tan, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

3724 Issued in HI

Practice address

55 Maui Lani Pkwy
Wailuku, HI 96793-2416

Phone

(808) 243-6000

NPI assigned

Aug 16, 2017

Last updated

Aug 16, 2017By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Stacy Haunani Terashita Former name

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Kaiser Foundation Health Plan Inc

  dba Kaiser Honolulu Clinic Radiology

  • Radiology Clinic/Center
  • Honolulu, HI
  • NPI 1063515567
  Medicare reassignment NPD
• Kaiser Foundation Health Plan Inc

  dba Kaiser Foundation Health Plan

  • Health Maintenance Organization
  • Honolulu, HI
  • NPI 1407862030
  NPD
• Kaiser Foundation Health Plan, Inc

  dba Kahuku Clinic

  • Rural Health Clinic/Center
  • Kahuku, HI
  • NPI 1245773936
  NPD

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

{
    "created_epoch": "1502841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502841600000",
    "number": "1952827438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "265 OHAOHA PL",
            "city": "MAKAWAO",
            "state": "HI",
            "postal_code": "967687709",
            "telephone_number": "808-352-3525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 MAUI LANI PKWY",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "967932416",
            "telephone_number": "808-243-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAN",
        "first_name": "STACY",
        "middle_name": "HAUNANI",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-16",
        "last_updated": "2017-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "HI",
            "license": "3724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACY",
            "last_name": "TERASHITA",
            "middle_name": "HAUNANI",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kasey-Kalei Anne Tamashiro, DMD
• Cynthia Meyer Tamayo, PT
• Naomi M Tamparong, NP-C
• Maura Michele D Tamplin, PT
• Andrew W. Tan, M.D.
• Marvin M. Tanaka, DDS, MS
• Jivin Gerard Tantisira, M.D.
• Melissa Taraya
• Cora Sayoko Tasaki, MD
• Mitchell N Tasaki, MD

• Clinical Social Worker in Wailuku, HI
• Providers in Wailuku, HI by specialty
• Clinical Social Worker in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.