Provider Demographics
NPI:1558485680
Name:MARTEN, ANN ROCHELLE (LCSW)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:ROCHELLE
Last Name:MARTEN
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 1:349 ILIMANO PL
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-1877
Mailing Address - Country:US
Mailing Address - Phone:808-228-3673
Mailing Address - Fax:
Practice Address - Street 1:25 KANEOHE BAY DR
Practice Address - Street 2:SUITE 204
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-1727
Practice Address - Country:US
Practice Address - Phone:808-228-3673
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI31811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical