Provider Demographics
NPI:1043645732
Name:NATIONAL CENTER FOR PTSD
Entity Type:Organization
Organization Name:NATIONAL CENTER FOR PTSD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DEPUTY DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MORLAND
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:808-566-1934
Mailing Address - Street 1:3375 KOAPAKA ST STE I560
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96819-5202
Mailing Address - Country:US
Mailing Address - Phone:808-954-6385
Mailing Address - Fax:
Practice Address - Street 1:3375 KOAPAKA ST STE I560
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96819-5202
Practice Address - Country:US
Practice Address - Phone:808-954-6385
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-12
Last Update Date:2013-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPSY 1416261QR1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1100XAmbulatory Health Care FacilitiesClinic/CenterResearch