Provider Demographics
NPI:1093911869
Name:THE HAWAII NEUROPSYCHOLOGY CENTER, LLC
Entity Type:Organization
Organization Name:THE HAWAII NEUROPSYCHOLOGY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:LEWIS
Authorized Official - Last Name:LIKEWISE
Authorized Official - Suffix:JR
Authorized Official - Credentials:PHD, JD
Authorized Official - Phone:808-585-9494
Mailing Address - Street 1:520 LUNALILO HOME RD UNIT 5403
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96825-1726
Mailing Address - Country:US
Mailing Address - Phone:808-395-6766
Mailing Address - Fax:
Practice Address - Street 1:1188 BISHOP ST
Practice Address - Street 2:SUITE #2701
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-3301
Practice Address - Country:US
Practice Address - Phone:808-585-9494
Practice Address - Fax:808-585-9414
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI954103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty