Provider Demographics
NPI:1487225488
Name:NAVARRO ISHIKI, MICHELE RL (LCSW, CSAC)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:RL
Last Name:NAVARRO ISHIKI
Suffix:
Gender:F
Credentials:LCSW, CSAC
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 790445
Mailing Address - Street 2:
Mailing Address - City:PAIA
Mailing Address - State:HI
Mailing Address - Zip Code:96779-0445
Mailing Address - Country:US
Mailing Address - Phone:808-276-7243
Mailing Address - Fax:
Practice Address - Street 1:48 PUAKOU PLACE
Practice Address - Street 2:
Practice Address - City:PAIA
Practice Address - State:HI
Practice Address - Zip Code:96779
Practice Address - Country:US
Practice Address - Phone:808-276-7243
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-09
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HILCSW-46371041C0700X
HI1745-13101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)