Provider Demographics
NPI:1932253796
Name:FOLEY, MICHAEL EDWARD (MSW)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:EDWARD
Last Name:FOLEY
Suffix:
Gender:M
Credentials:MSW
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 1201
Mailing Address - Street 2:
Mailing Address - City:KILAUEA
Mailing Address - State:HI
Mailing Address - Zip Code:96754-1201
Mailing Address - Country:US
Mailing Address - Phone:808-828-0746
Mailing Address - Fax:
Practice Address - Street 1:4374 KUKUI GROVE ST
Practice Address - Street 2:SUITE #102
Practice Address - City:LIHUE
Practice Address - State:HI
Practice Address - Zip Code:96766-2007
Practice Address - Country:US
Practice Address - Phone:808-651-8269
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HILCSW 30031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIS72221OtherKAISER
HI24842301Medicaid
HI6229OtherALOHACARE
HIS72221OtherKAISER
HIS72221Medicare UPIN