MEDICARE: DARLENE KAREN WADE MSW

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	1041C0700X	Clinical Social Worker	LCSW3168	HI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0000005926	OTHER	HI	HMSA
2	LCSW3168	OTHER	HI	MDX
3	2170634	OTHER	HI	UNIVERSITY HEALTH ALLIANC
4	0000005926	OTHER	HI	BLUE CROSS BLUE SHIELD
5	510372	OTHER	HI	SUMMERLIN, HMA, HMN
6	2912	OTHER	HI	ALOHACARE
7	LCSW3168	OTHER	HI	HMAA

General Provider Information

NPI Number	:	1578761474
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DARLENE KAREN WADE MSW

Provider Business Mailing Address
First Line	:	1188 BISHOP ST STE 3205
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96813-3313
Country	:	US
Telephone Number	:	808-545-7706
Fax Number	:	413-812-4219

Provider Business Practice Location Address
First Line	:	1188 BISHOP ST STE 3205
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96813-3313
Country	:	US
Telephone Number	:	808-545-7706
Fax Number	:	413-812-4219

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/03/2007
Last Update Date	:	07/09/2007

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