Provider Demographics
NPI:1972632214
Name:TRUBITT, ANITA (LCSW)
Entity Type:Individual
Prefix:
First Name:ANITA
Middle Name:
Last Name:TRUBITT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 PAPALANI ST
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-3518
Mailing Address - Country:US
Mailing Address - Phone:808-261-2524
Mailing Address - Fax:808-261-2524
Practice Address - Street 1:520 PAPALANI ST
Practice Address - Street 2:
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-3518
Practice Address - Country:US
Practice Address - Phone:808-261-2524
Practice Address - Fax:808-261-2524
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HILCSW30271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
HILCSW3027OtherLICENSE NUMBER