Provider Demographics
NPI:1588923825
Name:LD-ADHD CENTER OF HAWAII
Entity type:Organization
Organization Name:LD-ADHD CENTER OF HAWAII
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEAD CLINICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:TYSON
Authorized Official - Suffix:
Authorized Official - Credentials:PSY D
Authorized Official - Phone:808-955-4775
Mailing Address - Street 1:1110 UNIVERSITY AVE
Mailing Address - Street 2:SUITE 504
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96826-1540
Mailing Address - Country:US
Mailing Address - Phone:808-955-4775
Mailing Address - Fax:
Practice Address - Street 1:1110 UNIVERSITY AVE
Practice Address - Street 2:SUITE 504
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96826-1540
Practice Address - Country:US
Practice Address - Phone:808-955-4775
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-07
Last Update Date:2012-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1162103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty