Individual provider Active NPI

Deborah A. Withers, MSW, LICSW

  • Clinical Social Worker
  • Kapa'au, HI
National Provider Identifier
1568418135
Registry record updated Mar 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
106953 Issued in MA
Practice address
54-426 Kapaau Road
Kapaau, HI 96755
Phone
(978) 456-7705
Fax
(808) 209-8034
NPI assigned
May 25, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 4272 HI
Clinical Social Worker 1041C0700X 106953 MA Primary

Addresses

Primary practice location

54-426 Kapaau Road
Kapaau, HI 96755

Mailing address

PO Box 685
Kapaau, HI 96755-0685
Phone (978) 456-7705

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, HI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20051014000736 MA Practitioner - Clinical Social Worker 4587680905 Practice locations: West Tisbury, MA
I20180622000991 HI Practitioner - Clinical Social Worker 4587680905 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

56 -825 Waiolu Place
Hawi, HI 96719-0685
Phone (987) 456-7705

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4272HIMDClinical Social Worker
106953MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Deborah Withers LCSW Inc. Clinical CurrentSince Jun 28, 2022 Accepting new patients
Stephanie Davidoff, M.D., PH.D., LLC Single Specialty PastSince Jan 31, 2021 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677801600000",
    "number": "1568418135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 685",
            "city": "KAPAAU",
            "state": "HI",
            "postal_code": "967550685",
            "telephone_number": "978-456-7705",
            "fax_number": "978-456-7307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54-426 KAPAAU ROAD",
            "city": "KAPAAU",
            "state": "HI",
            "postal_code": "96755",
            "telephone_number": "978-456-7705",
            "fax_number": "808-209-8034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITHERS",
        "first_name": "DEBORAH",
        "middle_name": "A.",
        "name_prefix": "Ms.",
        "credential": "MSW, LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-25",
        "last_updated": "2023-03-03",
        "certification_date": "2023-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "HI",
            "license": "4272",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "106953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kapa'au, HI

Sources for this page

Verify at the official NPI Registry.