Provider Demographics
NPI:1760040844
Name:MCCLOUD, ELIZABETH (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:
Last Name:MCCLOUD
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:ELIZABETH
Other - Middle Name:
Other - Last Name:MCCLOUD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:154 WAIANUENUE AVE UNIT 11425
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96721-2115
Mailing Address - Country:US
Mailing Address - Phone:831-238-6326
Mailing Address - Fax:
Practice Address - Street 1:305 WAILUKU DR STE 3
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-2488
Practice Address - Country:US
Practice Address - Phone:831-238-6326
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-03
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPSY1904103TC0700X
CAPSY33504103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical