Healthcare Provider Details

I. General information

NPI: 1558481184
Provider Name (Legal Business Name): CHARLES THOMAS HARDING PSY.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/29/2007
Last Update Date: 06/13/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

860 FOURTH ST
PEARL CITY HI
96782-3312
US

IV. Provider business mailing address

PO BOX 3378
HONOLULU HI
96801-3378
US

V. Phone/Fax

Practice location:
  • Phone: 808-927-9038
  • Fax: 808-453-5966
Mailing address:
  • Phone: 808-927-9038
  • Fax: 808-586-4745

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: