Provider Demographics
NPI:1629405493
Name:HEATHER H. MCDERMOTT, PSY.D., LLC
Entity Type:Organization
Organization Name:HEATHER H. MCDERMOTT, PSY.D., LLC
Other - Org Name:ADULT AND CHILD PSYCHOLOGICAL SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:HENKEN
Authorized Official - Last Name:MCDERMOTT
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:808-781-2219
Mailing Address - Street 1:PO BOX 25052
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96825-0052
Mailing Address - Country:US
Mailing Address - Phone:808-285-4776
Mailing Address - Fax:
Practice Address - Street 1:1188 BISHOP ST STE 3005
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-3312
Practice Address - Country:US
Practice Address - Phone:808-285-4776
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-10
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPSY 1419103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty