Provider Demographics
NPI:1639438641
Name:WESTRA, KIRSTEN (MS, LMHC, LLC)
Entity Type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:
Last Name:WESTRA
Suffix:
Gender:F
Credentials:MS, LMHC, LLC
Other - Prefix:
Other - First Name:KIRSTEN
Other - Middle Name:
Other - Last Name:WESTRA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, LMHC
Mailing Address - Street 1:75-5995 KUAKINI HWY
Mailing Address - Street 2:SUITE 126
Mailing Address - City:KAILUA KONA
Mailing Address - State:HI
Mailing Address - Zip Code:96740-2144
Mailing Address - Country:US
Mailing Address - Phone:808-937-8007
Mailing Address - Fax:808-327-1361
Practice Address - Street 1:75-5995 KUAKINI HWY
Practice Address - Street 2:SUITE 126
Practice Address - City:KAILUA KONA
Practice Address - State:HI
Practice Address - Zip Code:96740-2144
Practice Address - Country:US
Practice Address - Phone:808-937-8007
Practice Address - Fax:808-327-1361
Is Sole Proprietor?:No
Enumeration Date:2012-05-10
Last Update Date:2014-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HILMHC3011041C0700X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No171M00000XOther Service ProvidersCase Manager/Care Coordinator