Individual provider Active NPI

Debra Ann O'Brien, LCSW, CAS

  • Clinical Social Worker
  • Honolulu, HI
National Provider Identifier
1003940651
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
3340 Issued in HI
Practice address
4224 Waialae Ave
# 5-513
Honolulu, HI 96816-5330
Phone
(808) 497-7244
NPI assigned
Mar 15, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 3340 HI Primary

Addresses

Primary practice location

4224 Waialae Ave
# 5-513
Honolulu, HI 96816-5330

Mailing address

4224 Waialae Ave
# 5-513
Honolulu, HI 96816-5330
Phone (808) 497-7244

Other identifiers 1

IdentifierTypeStateIssuer
23232-2OtherHIHMSA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190128001097 OR Practitioner - Clinical Social Worker 7618126038 Practice locations: Pendleton, OR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3340HIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
3-D Healthcare Services P.C. Past Accepting new patients
Ke Ola Mamo PastSince Jan 2, 2013 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003940651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4224 WAIALAE AVE",
            "address_2": "# 5-513",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968165330",
            "telephone_number": "808-497-7244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4224 WAIALAE AVE",
            "address_2": "# 5-513",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968165330",
            "telephone_number": "808-497-7244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "DEBRA",
        "middle_name": "ANN",
        "credential": "LCSW, CAS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "HI",
            "license": "3340",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA",
            "identifier": "23232-2",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.