Provider Demographics
NPI:1477688083
Name:ROBERT A. WOLF, LCSW INC
Entity Type:Organization
Organization Name:ROBERT A. WOLF, LCSW INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:A
Authorized Official - Last Name:WOLF
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:808-587-0242
Mailing Address - Street 1:1188 BISHOP ST
Mailing Address - Street 2:SUITE 1106
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-3301
Mailing Address - Country:US
Mailing Address - Phone:808-587-0242
Mailing Address - Fax:808-532-3323
Practice Address - Street 1:1188 BISHOP ST
Practice Address - Street 2:SUITE 1106
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-3301
Practice Address - Country:US
Practice Address - Phone:808-587-0242
Practice Address - Fax:808-532-3323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2013-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HILCSW-32011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI00A0249084OtherHMSA- 1188 BISHOP ST.
HI073347972OtherUHA
HI073347972OtherTRICARE
HI56100002Medicaid
HI0000249086OtherHMSA- 314 ULUNIU ST.
HI073347972OtherHMAA
HI56200001Medicaid
HI073347972OtherALOHA CARE
HI073347972OtherTRICARE
HIP86784Medicare ID - Type Unspecified
HI56200001Medicaid