Provider Demographics
NPI:1871032789
Name:TAKAHASHI, CHIE
Entity type:Individual
Prefix:
First Name:CHIE
Middle Name:
Last Name:TAKAHASHI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 30929
Mailing Address - Street 2:
Mailing Address - City:ANAHOLA
Mailing Address - State:HI
Mailing Address - Zip Code:96703-0929
Mailing Address - Country:US
Mailing Address - Phone:808-450-8828
Mailing Address - Fax:
Practice Address - Street 1:6751M KOOLAU RD
Practice Address - Street 2:
Practice Address - City:ANAHOLA
Practice Address - State:HI
Practice Address - Zip Code:96703
Practice Address - Country:US
Practice Address - Phone:808-450-8828
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-13
Last Update Date:2017-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HILCSW-37741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical