Healthcare Provider Details

I. General information

NPI: 1083334809
Provider Name (Legal Business Name): MR. KERBY WARD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2022
Last Update Date: 07/24/2025
Certification Date: 07/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

875 WAIMANU ST STE 600
HONOLULU HI
96813-5267
US

IV. Provider business mailing address

91-1841 FORT WEAVER RD
EWA BEACH HI
96706-1909
US

V. Phone/Fax

Practice location:
  • Phone: 808-533-3936
  • Fax:
Mailing address:
  • Phone: 808-681-3500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: