MEDICARE: HEATHER H. MCDERMOTT, PSY.D., LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist

General Provider Information

NPI Number	:	1629405493
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEATHER H. MCDERMOTT, PSY.D., LLC

Provider Business Mailing Address
First Line	:	1188 BISHOP ST STE 2204
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96813-3309
Country	:	US
Telephone Number	:	808-285-4776
Fax Number	:

Provider Business Practice Location Address
First Line	:	1188 BISHOP ST STE 2204
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96813-3309
Country	:	US
Telephone Number	:	808-285-4776
Fax Number	:

Authorized Official
Title or Position	:	MEMBER MANAGER
Name	:	DR. HEATHER HENKEN MCDERMOTT
Credential	:	PSY.D.
Telephone Number	:	808-781-2219

Provider Enumeration Date	:	10/10/2013
Last Update Date	:	12/04/2024

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