Provider Demographics
NPI:1073914941
Name:CARMENNE CHIASSON PHD INC
Entity Type:Organization
Organization Name:CARMENNE CHIASSON PHD INC
Other - Org Name:CARMENNE CHIASSON, PHD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:MS
Authorized Official - First Name:CARMENNE
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:CHIASSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:808-589-9158
Mailing Address - Street 1:1188 BISHOP ST STE 3512
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-3314
Mailing Address - Country:US
Mailing Address - Phone:808-589-9158
Mailing Address - Fax:
Practice Address - Street 1:389 KAIMAKE LOOP
Practice Address - Street 2:
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-2018
Practice Address - Country:US
Practice Address - Phone:808-589-9158
Practice Address - Fax:808-550-0992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-10
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPSY-645103TC0700X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty