Provider Demographics
NPI:1073656021
Name:WINDS OF CHANGE PSYCHOLOGICAL SERVICES
Entity Type:Organization
Organization Name:WINDS OF CHANGE PSYCHOLOGICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:808-332-8370
Mailing Address - Street 1:PO BOX 690107
Mailing Address - Street 2:
Mailing Address - City:MAKAWELI
Mailing Address - State:HI
Mailing Address - Zip Code:96769-0107
Mailing Address - Country:US
Mailing Address - Phone:808-332-8370
Mailing Address - Fax:808-332-6352
Practice Address - Street 1:2-2514 KAUMUALII HWY
Practice Address - Street 2:STE 104
Practice Address - City:KALAHEO
Practice Address - State:HI
Practice Address - Zip Code:96741-8303
Practice Address - Country:US
Practice Address - Phone:808-332-8370
Practice Address - Fax:808-332-6352
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-15
Last Update Date:2009-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI971103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty