Provider Demographics
NPI:1730309683
Name:ALAMODIN, LORI REIKO (MSW, LSW)
Entity Type:Individual
Prefix:MS
First Name:LORI
Middle Name:REIKO
Last Name:ALAMODIN
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:92-461 MAKAKILO DR
Mailing Address - Street 2:
Mailing Address - City:KAPOLEI
Mailing Address - State:HI
Mailing Address - Zip Code:96707-1270
Mailing Address - Country:US
Mailing Address - Phone:808-678-3814
Mailing Address - Fax:
Practice Address - Street 1:92-461 MAKAKILO DR
Practice Address - Street 2:
Practice Address - City:KAPOLEI
Practice Address - State:HI
Practice Address - Zip Code:96707-1270
Practice Address - Country:US
Practice Address - Phone:808-678-3814
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2011-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1444171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI104100000XOtherLICENSED SOCIAL WORKER
HI171M00000XOtherCARE COORDINATOR