Provider Demographics
NPI:1992927628
Name:MCLAUGHLIN, TINA LORRAINE (PSYD)
Entity type:Individual
Prefix:DR
First Name:TINA
Middle Name:LORRAINE
Last Name:MCLAUGHLIN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:606 CORAL ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-5135
Mailing Address - Country:US
Mailing Address - Phone:808-371-7259
Mailing Address - Fax:808-791-6198
Practice Address - Street 1:606 CORAL ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-5135
Practice Address - Country:US
Practice Address - Phone:808-371-7259
Practice Address - Fax:808-791-6198
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIHI PSY 455103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI07118001Medicaid
HI9253-6Medicare UPIN
HI07118001Medicaid