Provider Demographics
NPI:1205509544
Name:WESTLY, LISA MARIE (MHC)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:MARIE
Last Name:WESTLY
Suffix:
Gender:F
Credentials:MHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1036 HOA ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96825-3511
Mailing Address - Country:US
Mailing Address - Phone:808-354-7950
Mailing Address - Fax:
Practice Address - Street 1:1036 HOA ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96825-3511
Practice Address - Country:US
Practice Address - Phone:808-354-7950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-30
Last Update Date:2021-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI217101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
UNKNOWNOtherPRIVATE INSURANCE