Provider Demographics
NPI:1629392683
Name:SIMMONS, SHARI MEI LU (MSW)
Entity Type:Individual
Prefix:MRS
First Name:SHARI
Middle Name:MEI LU
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MISS
Other - First Name:SHARI
Other - Middle Name:MEI LU
Other - Last Name:YOUNG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:1576 HANAI LOOP
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-1801
Mailing Address - Country:US
Mailing Address - Phone:808-428-7990
Mailing Address - Fax:
Practice Address - Street 1:1576 HANAI LOOP
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-1801
Practice Address - Country:US
Practice Address - Phone:808-428-7990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-19
Last Update Date:2010-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI33111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical