Provider Demographics
NPI:1023597242
Name:CATHERINE SMITH LCSW, LLC
Entity type:Organization
Organization Name:CATHERINE SMITH LCSW, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:808-896-4002
Mailing Address - Street 1:PO BOX 607
Mailing Address - Street 2:
Mailing Address - City:HOLUALOA
Mailing Address - State:HI
Mailing Address - Zip Code:96725-0607
Mailing Address - Country:US
Mailing Address - Phone:808-896-4002
Mailing Address - Fax:888-883-7420
Practice Address - Street 1:75-159 LUNAPULE RD STE 8
Practice Address - Street 2:
Practice Address - City:KAILUA KONA
Practice Address - State:HI
Practice Address - Zip Code:96740-2100
Practice Address - Country:US
Practice Address - Phone:808-896-4002
Practice Address - Fax:888-883-7420
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-08
Last Update Date:2020-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI37231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty