Provider Demographics
NPI:1851692479
Name:YOUNG WOMEN'S CHRISTIAN ASSOCIATION
Entity Type:Organization
Organization Name:YOUNG WOMEN'S CHRISTIAN ASSOCIATION
Other - Org Name:YWCA OF KAUAI
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROGRAM MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:FALLON
Authorized Official - Last Name:LUZNEY
Authorized Official - Suffix:
Authorized Official - Credentials:MARRIAGE FAMILY THER
Authorized Official - Phone:808-245-5959
Mailing Address - Street 1:3094 ELUA ST
Mailing Address - Street 2:
Mailing Address - City:LIHUE
Mailing Address - State:HI
Mailing Address - Zip Code:96766-1209
Mailing Address - Country:US
Mailing Address - Phone:808-245-5959
Mailing Address - Fax:808-245-5961
Practice Address - Street 1:3094 ELUA ST
Practice Address - Street 2:
Practice Address - City:LIHUE
Practice Address - State:HI
Practice Address - Zip Code:96766-1209
Practice Address - Country:US
Practice Address - Phone:808-245-5959
Practice Address - Fax:808-245-5961
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-12
Last Update Date:2010-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI34491041C0700X
HI6106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty