Provider Demographics
NPI:1184810731
Name:HENRY L. JANPOL, ED.D., PSYCHOLOGIST, INC.
Entity type:Organization
Organization Name:HENRY L. JANPOL, ED.D., PSYCHOLOGIST, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:
Authorized Official - Last Name:JANPOL
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:808-250-4373
Mailing Address - Street 1:81 MAKAWAO AVE
Mailing Address - Street 2:SUITE 201-C
Mailing Address - City:MAKAWAO
Mailing Address - State:HI
Mailing Address - Zip Code:96768-8895
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:81 MAKAWAO AVE
Practice Address - Street 2:SUITE 201-C
Practice Address - City:MAKAWAO
Practice Address - State:HI
Practice Address - Zip Code:96768-8895
Practice Address - Country:US
Practice Address - Phone:808-250-4373
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-18
Last Update Date:2007-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI558103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI506694Medicaid