Individual provider Active NPI

Rachel Samantha Donahue Ebert, LCSW

  • Clinical Social Worker
  • Honolulu, HI
National Provider Identifier
1376986067
Registry record updated Sep 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2030 Issued in HI
Practice address
245 N Kukui St Ste 102a
Honolulu, HI 96817-3921
Phone
(808) 672-2932
NPI assigned
Apr 11, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 2030 HI
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 2030 HI Primary

Addresses

Primary practice location

245 N Kukui St Ste 102a
Honolulu, HI 96817-3921

Mailing address

245 N Kukui St Ste 102a
Honolulu, HI 96817-3921
Phone (808) 672-2932

Other names 1

  • Rachel Samantha Donahue Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2030HIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1365638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694390400000",
    "number": "1376986067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 N KUKUI ST STE 102A",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968173921",
            "telephone_number": "808-672-2932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 N KUKUI ST STE 102A",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968173921",
            "telephone_number": "808-672-2932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBERT",
        "first_name": "RACHEL",
        "middle_name": "SAMANTHA DONAHUE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-11",
        "last_updated": "2023-09-11",
        "certification_date": "2022-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "HI",
            "license": "2030",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "HI",
            "license": "2030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RACHEL",
            "last_name": "DONAHUE",
            "middle_name": "SAMANTHA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Honolulu, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.