Provider Demographics
NPI:1528215365
Name:CHONG, REUBEN (LCSW, CSAC)
Entity Type:Individual
Prefix:MR
First Name:REUBEN
Middle Name:
Last Name:CHONG
Suffix:
Gender:M
Credentials:LCSW, CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45-691 KEAAHALA RD
Mailing Address - Street 2:WOCMHC
Mailing Address - City:KANEOHE
Mailing Address - State:HI
Mailing Address - Zip Code:96744-3569
Mailing Address - Country:US
Mailing Address - Phone:808-233-3775
Mailing Address - Fax:808-233-3779
Practice Address - Street 1:45-691 KEAAHALA RD
Practice Address - Street 2:WOCMHC
Practice Address - City:KANEOHE
Practice Address - State:HI
Practice Address - Zip Code:96744-3569
Practice Address - Country:US
Practice Address - Phone:808-233-3775
Practice Address - Fax:808-233-3779
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-22
Last Update Date:2011-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI101YA0400X
104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)