Provider Demographics
NPI:1558301895
Name:KIEHL, JULIA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JULIA
Middle Name:
Last Name:KIEHL
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 1:68-155 AU STREET
Mailing Address - Street 2:#304
Mailing Address - City:WAIALUA
Mailing Address - State:HI
Mailing Address - Zip Code:96791
Mailing Address - Country:US
Mailing Address - Phone:808-277-8499
Mailing Address - Fax:808-621-0540
Practice Address - Street 1:319 A NORTH CANE ST
Practice Address - Street 2:
Practice Address - City:WAHIAWA
Practice Address - State:HI
Practice Address - Zip Code:96786
Practice Address - Country:US
Practice Address - Phone:808-621-1820
Practice Address - Fax:808-621-0540
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI30721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIH96811-01Medicaid