Provider Demographics
NPI:1487787966
Name:MCGINNESS, KATIE L (LCSW)
Entity type:Individual
Prefix:MRS
First Name:KATIE
Middle Name:L
Last Name:MCGINNESS
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 1:3-3420 KUHIO HWY STE B
Mailing Address - Street 2:
Mailing Address - City:LIHUE
Mailing Address - State:HI
Mailing Address - Zip Code:96766-1098
Mailing Address - Country:US
Mailing Address - Phone:808-246-1357
Mailing Address - Fax:808-246-1625
Practice Address - Street 1:KAUAI MEDICAL CLINIC
Practice Address - Street 2:3-3420 KUHIO HWY STE B
Practice Address - City:LIHUE
Practice Address - State:HI
Practice Address - Zip Code:96766-1098
Practice Address - Country:US
Practice Address - Phone:808-246-1357
Practice Address - Fax:808-246-1625
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2018-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HILCSW-42901041C0700X
CALCS 242341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical