Provider Demographics
NPI:1609006485
Name:BARRILLEAUX, CORAL LOUISE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:CORAL
Middle Name:LOUISE
Last Name:BARRILLEAUX
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:PO BOX 6231
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-8924
Mailing Address - Country:US
Mailing Address - Phone:808-756-2129
Mailing Address - Fax:
Practice Address - Street 1:120 KEAWA STREET
Practice Address - Street 2:SUITE 204A
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720
Practice Address - Country:US
Practice Address - Phone:808-756-2129
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-15
Last Update Date:2012-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI35761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical