Provider Demographics
NPI:1578761474
Name:WADE, DARLENE KAREN (MSW)
Entity Type:Individual
Prefix:
First Name:DARLENE
Middle Name:KAREN
Last Name:WADE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1188 BISHOP ST STE 3205
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-3313
Mailing Address - Country:US
Mailing Address - Phone:808-545-7706
Mailing Address - Fax:413-812-4219
Practice Address - Street 1:1188 BISHOP ST STE 3205
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-3313
Practice Address - Country:US
Practice Address - Phone:808-545-7706
Practice Address - Fax:413-812-4219
Is Sole Proprietor?:No
Enumeration Date:2007-07-03
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HILCSW31681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI0000005926OtherHMSA
HILCSW3168OtherMDX
HI2170634OtherUNIVERSITY HEALTH ALLIANC
HI0000005926OtherBLUE CROSS BLUE SHIELD
HI510372OtherSUMMERLIN, HMA, HMN
HI2912OtherALOHACARE
HILCSW3168OtherHMAA
HI0000TMSXGMedicare ID - Type UnspecifiedMEDICARE
HIS30328Medicare UPIN