Healthcare Provider Details

I. General information

NPI: 1790735629
Provider Name (Legal Business Name): ANDREW DAHLBURG LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

VAPIHCS 459 PATTERSON ROAD
HONOLULU HI
96819
US

IV. Provider business mailing address

VAPIHCS 459 PATTERSON ROAD
HONOLULU HI
96819
US

V. Phone/Fax

Practice location:
  • Phone: 808-433-0332
  • Fax:
Mailing address:
  • Phone: 808-433-0332
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number1110-02
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number3301
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: