Provider Demographics
NPI:1477728665
Name:LAVIOLA, ANITA LOUISE (LCSW)
Entity Type:Individual
Prefix:
First Name:ANITA
Middle Name:LOUISE
Last Name:LAVIOLA
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 1:2200 MAIN ST STE 528
Mailing Address - Street 2:
Mailing Address - City:WAILUKU
Mailing Address - State:HI
Mailing Address - Zip Code:96793-1640
Mailing Address - Country:US
Mailing Address - Phone:808-281-2340
Mailing Address - Fax:
Practice Address - Street 1:2200 MAIN ST STE 528
Practice Address - Street 2:
Practice Address - City:WAILUKU
Practice Address - State:HI
Practice Address - Zip Code:96793-1640
Practice Address - Country:US
Practice Address - Phone:808-281-2340
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-28
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HILCSW 30411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical