Provider Demographics
NPI:1508511205
Name:MAUREEN MENCH, PSYD.,LLC
Entity Type:Organization
Organization Name:MAUREEN MENCH, PSYD.,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MAUREEN
Authorized Official - Middle Name:EDAH
Authorized Official - Last Name:MENCH
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:808-394-7830
Mailing Address - Street 1:1464 ULUHALA PL
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-4413
Mailing Address - Country:US
Mailing Address - Phone:808-394-7830
Mailing Address - Fax:808-620-7723
Practice Address - Street 1:337 ULUNIU ST STE 201
Practice Address - Street 2:
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-2508
Practice Address - Country:US
Practice Address - Phone:808-394-7830
Practice Address - Fax:808-720-6623
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-21
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health