Provider Demographics
NPI:1871687657
Name:WHITE, ISAAC JR (MSW)
Entity Type:Individual
Prefix:MR
First Name:ISAAC
Middle Name:
Last Name:WHITE
Suffix:JR
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73-1052 AHIKAWA STREET
Mailing Address - Street 2:
Mailing Address - City:KAILUA-KONA
Mailing Address - State:HI
Mailing Address - Zip Code:96740
Mailing Address - Country:US
Mailing Address - Phone:808-325-2095
Mailing Address - Fax:
Practice Address - Street 1:75-5995 KUAKINI HWY
Practice Address - Street 2:STE #413 DEPT OF VETERANS AFFAIRS
Practice Address - City:KAILUA-KONA
Practice Address - State:HI
Practice Address - Zip Code:96740
Practice Address - Country:US
Practice Address - Phone:808-329-0774
Practice Address - Fax:808-329-0776
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HILSW1258104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker