| Diane Logan Llc | |
|
75-127 Lunapule Rd Ste 15b Kailua Kona HI 96740-2119 | |
| (808) 437-7447 | |
| (808) 374-9046 |
| Full Name | Diane Logan Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 75-127 Lunapule Rd Ste 15b, Kailua Kona, Hawaii |
| Authorized Official Name and Position | Diane E Logan (OWNER) |
| Authorized Official Contact | 8084377447 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Diane Logan Llc Po Box 5488 Kailua Kona HI 96745-5488 Ph: (808) 437-7447 | Diane Logan Llc 75-127 Lunapule Rd Ste 15b Kailua Kona HI 96740-2119 Ph: (808) 437-7447 |
| NPI Number | 1265068233 |
|---|---|
| Provider Enumeration Date | 03/20/2020 |
| Last Update Date | 10/06/2021 |
| Certification Date | 10/06/2021 |
| Medicare PECOS PAC ID | 5496185613 |
|---|---|
| Medicare Enrollment ID | O20200430000794 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265068233 | NPI | - | NPPES |
| Provider Name | Diane E Logan |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1003207259 PECOS PAC ID: 3072820901 Enrollment ID: I20150909003084 |
Wallace R. Shrinski, Mft Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 75-127 Lunapule Rd, 15b, Kailua Kona, HI 96740 Phone: 808-987-7306 | |
Catherine Smith Lcsw, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 75-159 Lunapule Rd Ste 8, Kailua Kona, HI 96740 Phone: 808-896-4002 Fax: 888-883-7420 | |
Roger A Weiss, Inc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 75-5744 Alii Dr, Kailua Kona, HI 96740 Phone: 808-329-7999 | |
Akamia Wellness Servies Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 73-4322 Keokeo St, Kailua Kona, HI 96740 Phone: 808-938-4162 | |
Dana Moody Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 75-127 Lunapule Rd, Suite 1a, Kailua Kona, HI 96740 Phone: 808-430-6159 | |
Sophia J. Wang, Phd Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 76-6225 Kuakini Hwy, Suite C-103, Kailua Kona, HI 96740 Phone: 808-329-7176 |