Provider Demographics
NPI:1629403449
Name:SERKIS, LAUREN GRAY MCCARTHA (MSCP)
Entity Type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:GRAY MCCARTHA
Last Name:SERKIS
Suffix:
Gender:F
Credentials:MSCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1485 LINAPUNI ST RM 105
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96819-3575
Mailing Address - Country:US
Mailing Address - Phone:808-843-5312
Mailing Address - Fax:808-848-2069
Practice Address - Street 1:1485 LINAPUNI ST RM 105
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96819-3575
Practice Address - Country:US
Practice Address - Phone:808-843-5312
Practice Address - Fax:808-848-2069
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-11
Last Update Date:2020-02-08
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health