Provider Demographics
NPI:1417000654
Name:LARRY-FIAKPUYI, EREAN A (LCSW)
Entity Type:Individual
Prefix:MS
First Name:EREAN
Middle Name:A
Last Name:LARRY-FIAKPUYI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:EREAN
Other - Middle Name:
Other - Last Name:LARRY-FIAKPUYI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:451 NAHUA STREET
Mailing Address - Street 2:#803
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96815
Mailing Address - Country:US
Mailing Address - Phone:916-883-9935
Mailing Address - Fax:
Practice Address - Street 1:952 NORTH KING STREET
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817
Practice Address - Country:US
Practice Address - Phone:808-841-6318
Practice Address - Fax:808-841-2591
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA772991041C0700X
HI41281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical