Provider Demographics
NPI:1265006977
Name:MAYEHARA, GINGER (LCSW)
Entity type:Individual
Prefix:
First Name:GINGER
Middle Name:
Last Name:MAYEHARA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:336 N KUAKINI ST APT 322
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-2346
Mailing Address - Country:US
Mailing Address - Phone:808-232-4650
Mailing Address - Fax:
Practice Address - Street 1:336 N KUAKINI ST APT 322
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-2346
Practice Address - Country:US
Practice Address - Phone:808-232-4650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-17
Last Update Date:2021-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HILCSW-46341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical