Healthcare Provider Details

I. General information

NPI: 1477688083
Provider Name (Legal Business Name): ROBERT A. WOLF, LCSW INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2007
Last Update Date: 11/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1188 BISHOP ST SUITE 1106
HONOLULU HI
96813-3301
US

IV. Provider business mailing address

1188 BISHOP ST SUITE 1106
HONOLULU HI
96813-3301
US

V. Phone/Fax

Practice location:
  • Phone: 808-587-0242
  • Fax: 808-532-3323
Mailing address:
  • Phone: 808-587-0242
  • Fax: 808-532-3323

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW-3201
License Number StateHI

VIII. Authorized Official

Name: MR. ROBERT A WOLF
Title or Position: PRESIDENT
Credential: L.C.S.W.
Phone: 808-587-0242