Healthcare Provider Details

I. General information

NPI: 1821232430
Provider Name (Legal Business Name): MARGARET CATHERINE SHEPHERD LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/27/2009
Last Update Date: 04/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

597 PAHI KA STREET
PAIA HI
96779
US

IV. Provider business mailing address

597 PAHI KA STREET
PAIA HI
96779
US

V. Phone/Fax

Practice location:
  • Phone: 808-579-6485
  • Fax: 808-877-4443
Mailing address:
  • Phone: 808-579-6485
  • Fax: 808-877-0880

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW3510
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: