Provider Demographics
NPI:1396141024
Name:MAUI PSYCHIATRY LLC
Entity type:Organization
Organization Name:MAUI PSYCHIATRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF PSYCHIATRIST/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:D'ARCY
Authorized Official - Last Name:BANKS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-244-1003
Mailing Address - Street 1:161 WAILEA IKE PL
Mailing Address - Street 2:BLDG A105, SUITE 5
Mailing Address - City:WAILEA
Mailing Address - State:HI
Mailing Address - Zip Code:96753-6521
Mailing Address - Country:US
Mailing Address - Phone:808-244-1003
Mailing Address - Fax:
Practice Address - Street 1:161 WAILEA IKE PL
Practice Address - Street 2:BLDG A105, SUITE 5
Practice Address - City:WAILEA
Practice Address - State:HI
Practice Address - Zip Code:96753-6521
Practice Address - Country:US
Practice Address - Phone:808-244-1003
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-06
Last Update Date:2014-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD4259102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalystGroup - Single Specialty