Provider Demographics
NPI:1821707761
Name:IMADA, JOY HIROMI (MSW, LSW)
Entity Type:Individual
Prefix:
First Name:JOY
Middle Name:HIROMI
Last Name:IMADA
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 1:3446 KUPAA DR
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-2504
Mailing Address - Country:US
Mailing Address - Phone:808-386-8729
Mailing Address - Fax:
Practice Address - Street 1:438 HOBRON LN STE 314
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96815-1242
Practice Address - Country:US
Practice Address - Phone:808-913-8840
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-18
Last Update Date:2022-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HILSW-3033104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty