Provider Demographics
NPI:1447578158
Name:VOELLER, MICHELLE RENE (LCSW-3527)
Entity Type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:RENE
Last Name:VOELLER
Suffix:
Gender:F
Credentials:LCSW-3527
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1614 EMERSON ST APT 17
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-2140
Mailing Address - Country:US
Mailing Address - Phone:808-721-6738
Mailing Address - Fax:
Practice Address - Street 1:1833 KALAKAUA AVE STE 409
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96815-1515
Practice Address - Country:US
Practice Address - Phone:808-721-6738
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-06
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HILCSW-35271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIUPINMedicare UPIN