Individual
MIRIAM GOLDBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, CAMS-II
Contact information
Practice address
3422 UPPER ST, HONOLULU, HI 96815-4337
(808) 651-6278
(808) 356-0634
Mailing address
3422 UPPER ST, HONOLULU, HI 96815-4337
(808) 651-6278
(808) 356-0634
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
4035
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000390294
HMSA PROVIDER #
HI
01
—
1932625902
NPI 2
HI
05
—
818388
—
HI
01
—
GE-005-883-5968-01
GENERAL EXCISE
HI
01
—
U070996
UPIN
HI
Enumeration date
07/28/2014
Last updated
11/16/2020
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