Provider Demographics
NPI:1700921236
Name:CHARLES, HONEY ANN FRIEND (LSW)
Entity Type:Individual
Prefix:MRS
First Name:HONEY
Middle Name:ANN FRIEND
Last Name:CHARLES
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:MRS
Other - First Name:HONEY
Other - Middle Name:ANN FRIEND
Other - Last Name:SCHMIMELFENNING
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LSW
Mailing Address - Street 1:4370 KUKUI GROVE STREET
Mailing Address - Street 2:SUITE 3-211
Mailing Address - City:LIHUE
Mailing Address - State:HI
Mailing Address - Zip Code:96766
Mailing Address - Country:US
Mailing Address - Phone:808-274-3190
Mailing Address - Fax:808-274-3194
Practice Address - Street 1:4370 KUKUI GROVE STREET
Practice Address - Street 2:SUITE 3-211
Practice Address - City:LIHUE
Practice Address - State:HI
Practice Address - Zip Code:96766
Practice Address - Country:US
Practice Address - Phone:808-274-3190
Practice Address - Fax:808-274-3194
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2015-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HILSW 558104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI53937201Medicaid
HI53937201Medicaid
S30076Medicare UPIN