Provider Demographics
NPI:1497951271
Name:TERENCE C WADE PHD INC
Entity type:Organization
Organization Name:TERENCE C WADE PHD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DARLENE
Authorized Official - Middle Name:K
Authorized Official - Last Name:WADE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:808-545-7706
Mailing Address - Street 1:1188 BISHOP ST STE 3205
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-3313
Mailing Address - Country:US
Mailing Address - Phone:808-545-7706
Mailing Address - Fax:413-812-4219
Practice Address - Street 1:1188 BISHOP ST STE 3205
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-3313
Practice Address - Country:US
Practice Address - Phone:808-545-7706
Practice Address - Fax:413-812-4219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPSY161103TC0700X
HILCSW31681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI2911OtherALOHACARE ID
HI9911634OtherUHA ID
HIB002OtherTRICARE ID
HILSCW3168OtherMDX HAWAII ID
HIPSY161OtherHMAA ID
HI0000005926OtherHMSA ID
HI2912OtherALOHACARE ID
HI208654OtherSUMMERLIN, HMA, HMN ID
HI2170634OtherUHA ID
HIB003OtherTRICARE ID
HI05365701Medicaid
HIPSY161OtherMDX HAWAII ID
HI0000061655OtherHMSA ID
HILCSW3168OtherHMAA ID
HI510372OtherSUMMERLIN, HMA, HMN ID
HI0000TMSXGMedicare ID - Type UnspecifiedMEDICARE ID
HILSCW3168OtherMDX HAWAII ID
HIB003OtherTRICARE ID