Provider Demographics
NPI:1154089357
Name:PIERCE, REBECCA TAYLOR (MSW, LSW, CSW)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:TAYLOR
Last Name:PIERCE
Suffix:
Gender:F
Credentials:MSW, LSW, CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59-547 AUKAUKA PL
Mailing Address - Street 2:
Mailing Address - City:HALEIWA
Mailing Address - State:HI
Mailing Address - Zip Code:96712-9520
Mailing Address - Country:US
Mailing Address - Phone:808-347-1246
Mailing Address - Fax:
Practice Address - Street 1:59-547 AUKAUKA PL
Practice Address - Street 2:
Practice Address - City:HALEIWA
Practice Address - State:HI
Practice Address - Zip Code:96712-9520
Practice Address - Country:US
Practice Address - Phone:808-347-1246
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-04
Last Update Date:2021-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
HILSW-2913-0104100000X
UT12538276-3502104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101Y00000XBehavioral Health & Social Service ProvidersCounselor