Provider Demographics
NPI:1255476354
Name:CARINGER, ELLEN RAE (PHD)
Entity Type:Individual
Prefix:DR
First Name:ELLEN
Middle Name:RAE
Last Name:CARINGER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1885 MAIN ST
Mailing Address - Street 2:SUITE 207
Mailing Address - City:WAILUKU
Mailing Address - State:HI
Mailing Address - Zip Code:96793-1819
Mailing Address - Country:US
Mailing Address - Phone:808-249-0253
Mailing Address - Fax:808-249-0223
Practice Address - Street 1:1885 MAIN ST
Practice Address - Street 2:SUITE 207
Practice Address - City:WAILUKU
Practice Address - State:HI
Practice Address - Zip Code:96793-1819
Practice Address - Country:US
Practice Address - Phone:808-249-0253
Practice Address - Fax:808-249-0223
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPSY 347103G00000X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI9891OtherKAISER PROVIDER NUMBER
HID2663-5OtherHMSA PROVIDER NUMBER
HI9891OtherKAISER PROVIDER NUMBER