Healthcare Provider Details

I. General information

NPI: 1629229828
Provider Name (Legal Business Name): SHERRY J HADDAD MA COUN PSYCH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SHERRY FISHER

II. Dates (important events)

Enumeration Date: 10/06/2008
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 ALOHA AINA PLACE
HAIKU HI
96708-5456
US

IV. Provider business mailing address

PO BOX 791507
PAIA HI
96779-1507
US

V. Phone/Fax

Practice location:
  • Phone: 808-205-2482
  • Fax:
Mailing address:
  • Phone: 808-205-2482
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code305S00000X
TaxonomyPoint of Service
License NumberMHC-350
License Number StateHI
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: