Provider Demographics
NPI:1811065774
Name:RATH, MICHAEL HAROLD (LCSW)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:HAROLD
Last Name:RATH
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1040 KAHILI ST
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-4050
Mailing Address - Country:US
Mailing Address - Phone:808-372-1787
Mailing Address - Fax:808-427-3058
Practice Address - Street 1:1040 KAHILI ST
Practice Address - Street 2:
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-4050
Practice Address - Country:US
Practice Address - Phone:808-372-1787
Practice Address - Fax:808-427-3058
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2019-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker