Provider Demographics
NPI:1366775751
Name:HALE, KRISTEN A (LCSW)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:A
Last Name:HALE
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:PO BOX 5003
Mailing Address - Street 2:
Mailing Address - City:KAILUA KONA
Mailing Address - State:HI
Mailing Address - Zip Code:96745-5003
Mailing Address - Country:US
Mailing Address - Phone:709-799-4942
Mailing Address - Fax:808-442-3152
Practice Address - Street 1:75-5706 HANAMA PL STE 106D
Practice Address - Street 2:
Practice Address - City:KAILUA KONA
Practice Address - State:HI
Practice Address - Zip Code:96740-1713
Practice Address - Country:US
Practice Address - Phone:808-295-8052
Practice Address - Fax:808-442-3152
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-16
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI44781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical