Provider Demographics
NPI:1053523977
Name:RIVAS, LAVERNE LANIUMA (LCSW BCD)
Entity type:Individual
Prefix:MRS
First Name:LAVERNE
Middle Name:LANIUMA
Last Name:RIVAS
Suffix:
Gender:F
Credentials:LCSW BCD
Other - Prefix:MRS
Other - First Name:LAVERNE
Other - Middle Name:LANIUMA
Other - Last Name:TONG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW BCD
Mailing Address - Street 1:PO BOX 968
Mailing Address - Street 2:
Mailing Address - City:HALEIWA
Mailing Address - State:HI
Mailing Address - Zip Code:96712
Mailing Address - Country:US
Mailing Address - Phone:808-722-0892
Mailing Address - Fax:808-848-2069
Practice Address - Street 1:1485 LINAPUNI ST.
Practice Address - Street 2:STE 105
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96819
Practice Address - Country:US
Practice Address - Phone:808-722-0892
Practice Address - Fax:808-848-2069
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI33361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical