Provider Demographics
NPI:1801103494
Name:HART, CATHERINE ALICE (LISW)
Entity type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:ALICE
Last Name:HART
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 868
Mailing Address - Street 2:
Mailing Address - City:KAPAAU
Mailing Address - State:HI
Mailing Address - Zip Code:96755-0868
Mailing Address - Country:US
Mailing Address - Phone:808-767-3084
Mailing Address - Fax:888-758-2782
Practice Address - Street 1:65-1230 MAMALAHOA HWY
Practice Address - Street 2:
Practice Address - City:KAMUELA
Practice Address - State:HI
Practice Address - Zip Code:96743-8318
Practice Address - Country:US
Practice Address - Phone:808-767-3084
Practice Address - Fax:888-758-2782
Is Sole Proprietor?:No
Enumeration Date:2010-09-03
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH09002121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical