Provider Demographics
NPI:1619013497
Name:REED, WALTER FREDERICK (MFT, CSAC)
Entity Type:Individual
Prefix:MR
First Name:WALTER
Middle Name:FREDERICK
Last Name:REED
Suffix:
Gender:M
Credentials:MFT, CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 WAI NANI WAY
Mailing Address - Street 2:#815
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96815
Mailing Address - Country:US
Mailing Address - Phone:808-852-9646
Mailing Address - Fax:
Practice Address - Street 1:99-128 AIEA HEIGHTS DRIVE
Practice Address - Street 2:#704
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701
Practice Address - Country:US
Practice Address - Phone:808-852-9646
Practice Address - Fax:808-484-9400
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2010-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
HI176106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No104100000XBehavioral Health & Social Service ProvidersSocial Worker