Provider Demographics
NPI:1568801702
Name:CASUPANG, LIANNE MSL (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:LIANNE
Middle Name:MSL
Last Name:CASUPANG
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:MISS
Other - First Name:LIANNE
Other - Middle Name:MEI SIU
Other - Last Name:LAU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:400 SAND ISLAND PKWY
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96819-4326
Mailing Address - Country:US
Mailing Address - Phone:808-842-2087
Mailing Address - Fax:808-842-2098
Practice Address - Street 1:400 SAND ISLAND PKWY
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96819-4326
Practice Address - Country:US
Practice Address - Phone:808-842-2087
Practice Address - Fax:808-842-2098
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-20
Last Update Date:2014-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMHC13101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health