Provider Demographics
NPI:1659358497
Name:KREINIK, KATHLEEN ANN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:ANN
Last Name:KREINIK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:KATHI
Other - Middle Name:A
Other - Last Name:KREINIK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:45-013 LILIPUNA RD
Mailing Address - Street 2:
Mailing Address - City:KANEOHE
Mailing Address - State:HI
Mailing Address - Zip Code:96744-3019
Mailing Address - Country:US
Mailing Address - Phone:808-235-1157
Mailing Address - Fax:
Practice Address - Street 1:TRIPLER ARMY MEDICAL CENTER ATTN: MCHK-QS
Practice Address - Street 2:1 JARRETT WHITE ROAD
Practice Address - City:TRIPLER
Practice Address - State:HI
Practice Address - Zip Code:96859-5001
Practice Address - Country:US
Practice Address - Phone:808-433-4561
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HILCSW 30351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical