MEDICARE: ADHD WELLNESS CLINIC

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	2084P0800X	Psychiatry Physician

General Provider Information

NPI Number	:	1922812650
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADHD WELLNESS CLINIC

Provider Business Mailing Address
First Line	:	500 ALA MOANA BLVD STE 7400
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96813-4902
Country	:	US
Telephone Number	:	808-563-4128
Fax Number	:	619-415-8415

Provider Business Practice Location Address
First Line	:	1000 AUAHI STREET #3711
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96813
Country	:	US
Telephone Number	:	619-613-2791
Fax Number	:	619-415-8415

Authorized Official
Title or Position	:	OWNER
Name	:	DANIEL THOMAS MATTOX
Credential	:	PMHNP-BC
Telephone Number	:	626-848-6670

Provider Enumeration Date	:	02/04/2025
Last Update Date	:	06/16/2026

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