Organization Active NPI

Psychology Hawaii LLC

  • Clinical Psychologist
  • Honolulu, HI
National Provider Identifier
1962882340
Registry record updated Jun 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY-1418 Issued in HI
Legal business name
PSYCHOLOGY HAWAII LLC
Practice address
928 Nuuanu Ave # LL2
Valden Medical
Honolulu, HI 96817-5190
Phone
(808) 538-2800
Fax
(808) 536-2024
NPI assigned
Jun 1, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2016

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

Authorized official

Name
Kelly Hoolani
Title
Office Manager/Valden Medical
Phone
(808) 538-2800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X PSY-1418 HI Primary

Addresses

Primary practice location

928 Nuuanu Ave # LL2
Valden Medical
Honolulu, HI 96817-5190

Mailing address

928 Nuuanu Ave # LLS2
Valden Medical
Honolulu, HI 96817-5190
Phone (808) 538-2800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150714001188 HI Part B Supplier - Clinic/Group Practice 4385957760 Receives reassigned benefits from 1 practitioner
Practice locations: Honolulu, HI

National Provider Directory

National Provider Directory

Locations

928 Nuuanu Ave
#2
Honolulu, HI 96817
Phone (808) 400-6473

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1433116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466985600000",
    "number": "1962882340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "928 NUUANU AVE # LLS2",
            "address_2": "VALDEN MEDICAL",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968175190",
            "telephone_number": "808-538-2800",
            "fax_number": "808-536-2024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "928 NUUANU AVE # LL2",
            "address_2": "VALDEN MEDICAL",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968175190",
            "telephone_number": "808-538-2800",
            "fax_number": "808-536-2024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHOLOGY HAWAII LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-01",
        "last_updated": "2016-06-27",
        "status": "A",
        "authorized_official_last_name": "HOOLANI",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "OFFICE MANAGER/VALDEN MEDICAL",
        "authorized_official_telephone_number": "808-538-2800"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "HI",
            "license": "PSY-1418",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jun 27, 2016; 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.