Provider Demographics
NPI:1104010735
Name:DEAN, TARYN ELIZABETH (LCSW)
Entity Type:Individual
Prefix:MS
First Name:TARYN
Middle Name:ELIZABETH
Last Name:DEAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 PAOPUA LOOP
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-3537
Mailing Address - Country:US
Mailing Address - Phone:808-371-8750
Mailing Address - Fax:
Practice Address - Street 1:175 KIHAPAI ST
Practice Address - Street 2:
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-2667
Practice Address - Country:US
Practice Address - Phone:808-371-8750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-27
Last Update Date:2014-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI33941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical