Provider Demographics
NPI:1770678625
Name:HOLDEN, VICKI WARD (LCSW)
Entity Type:Individual
Prefix:
First Name:VICKI
Middle Name:WARD
Last Name:HOLDEN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:VICKI
Other - Middle Name:LYNN
Other - Last Name:WARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:1130 N NIMITZ
Mailing Address - Street 2:SUITE C301
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96819
Mailing Address - Country:US
Mailing Address - Phone:808-535-1708
Mailing Address - Fax:808-845-7955
Practice Address - Street 1:1130 N NIMITZ
Practice Address - Street 2:SUITE C301
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96819
Practice Address - Country:US
Practice Address - Phone:808-535-1708
Practice Address - Fax:808-845-7955
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2013-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34005222A1041C0700X
HI37551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical