Provider Demographics
NPI:1750331989
Name:GROPPENBACHER, JOHN CONRAD (CSW)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:CONRAD
Last Name:GROPPENBACHER
Suffix:
Gender:M
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2319 ALA WAI BLVD
Mailing Address - Street 2:APT #102
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96815-2638
Mailing Address - Country:US
Mailing Address - Phone:808-433-0662
Mailing Address - Fax:808-433-0395
Practice Address - Street 1:459 PATTERSON RD
Practice Address - Street 2:116
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96819-1522
Practice Address - Country:US
Practice Address - Phone:808-433-0662
Practice Address - Fax:808-433-0395
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI3256101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)