DR. MARCUS VANSICKLE


Address: 503 Beard Ave # B, Honolulu, HI 96818-4957
Phone: 5714264753

DR. MARCUS VANSICKLE (NPI# 1043666506) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1043666506
Entity Type Individual
Full Name DR. MARCUS VANSICKLE
Credential PH.D., ABPP, MSCP
Practice Address 503 Beard Ave # B
Honolulu
HI 96818-4957
Practice Telephone 5714264753
Enumeration Date 2016-05-13
Last Update Date 2020-01-01
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 103T00000X Psychologist Behavioral Health & Social Service Providers
Y 103TP0016X Psychologist
Specialization: Prescribing (Medical)
321492 LA Behavioral Health & Social Service Providers

Provider Secondary Practice Location

Address Telephone Number Fax Number
470 Middle St Unit 220, Portsmouth, VA 237042833 5714264753

Office Location

Street Address 503 BEARD AVE # B
City HONOLULU
State HI
Zip Code 96818-4957

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Taxonomy Information

Taxonomy Code 103TP0016X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist
Specialization Prescribing (Medical)

Taxonomy Definition

Those licensed psychologists who have completed specialized, post-doctoral training in psychopharmacology, passed a national proficiency examination in psychopharmacology, and who are authorized by state statute to prescribe medications, in accordance with their state law and state licensing authority, for the evaluation, diagnosis, management and treatment of mental, nervous, emotional, behavioral, and related disorders.
Notes: Source: Louisiana Academy of Medical Psychologists Note: Some states issue licenses under Medical Psychologist. [1/1/2007: new]

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1437541281 Onmp Inc Psychologist 99-128 Aiea Heights Dr, Ste 704, Aiea, HI 96701-3925 2015-03-02
1588872790 Sim E. Granoff Psychologist 95-973 Wikao St, Mililani, HI 96789-3966 2007-05-19

Competitor

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City HONOLULU
Zip Code 96818

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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