Provider Demographics
NPI:1023518057
Name:HEATHER MCDERMOTT PSYD PLLC
Entity type:Organization
Organization Name:HEATHER MCDERMOTT PSYD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:MCDERMOTT
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:808-285-4776
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 1:2143 CLIFF RD
Practice Address - Street 2:
Practice Address - City:PORT AUSTIN
Practice Address - State:MI
Practice Address - Zip Code:48467-9261
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:2018-02-16
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty