Provider Demographics
NPI:1255466991
Name:CHOY-GIBSON, MARILYN KEIKILANI SR (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MARILYN
Middle Name:KEIKILANI
Last Name:CHOY-GIBSON
Suffix:SR
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 1:45-412 KONALE PL
Mailing Address - Street 2:
Mailing Address - City:KANEOHE
Mailing Address - State:HI
Mailing Address - Zip Code:96744-2116
Mailing Address - Country:US
Mailing Address - Phone:808-225-4279
Mailing Address - Fax:
Practice Address - Street 1:1481 S KING ST
Practice Address - Street 2:544
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-2506
Practice Address - Country:US
Practice Address - Phone:808-225-4279
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-22
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HILCSW 32061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI57654801Medicaid
HI0 025116-5OtherHMSA