Provider Demographics
NPI:1164770954
Name:WHIPPLE, RACHEL E (LCSW)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:E
Last Name:WHIPPLE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47-610 HUI ULILI ST APT A
Mailing Address - Street 2:
Mailing Address - City:KANEOHE
Mailing Address - State:HI
Mailing Address - Zip Code:96744-4642
Mailing Address - Country:US
Mailing Address - Phone:808-780-7603
Mailing Address - Fax:
Practice Address - Street 1:315 ULUNIU ST STE 207
Practice Address - Street 2:
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-2523
Practice Address - Country:US
Practice Address - Phone:808-261-0066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-27
Last Update Date:2018-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
HILCSW40281041C0700X
HILCSW 40281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial Worker