Provider Demographics
NPI:1891033502
Name:PIEKARZ, JOANNA (LSW)
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:
Last Name:PIEKARZ
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:349 HANAKAI ST STE C
Mailing Address - Street 2:
Mailing Address - City:KAHULUI
Mailing Address - State:HI
Mailing Address - Zip Code:96732-3414
Mailing Address - Country:US
Mailing Address - Phone:808-269-1016
Mailing Address - Fax:
Practice Address - Street 1:349 HANAKAI ST STE C
Practice Address - Street 2:
Practice Address - City:KAHULUI
Practice Address - State:HI
Practice Address - Zip Code:96732-3414
Practice Address - Country:US
Practice Address - Phone:808-269-1016
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-30
Last Update Date:2013-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HILSW # 1870104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI628886Medicaid
HI105854OtherAPS HEALTHCARE