Provider Demographics
NPI:1396439949
Name:ST-LAURENT, CAROLINE (LCSW)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:
Last Name:ST-LAURENT
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 1:1925 KALAKAUA AVE APT 2701
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96815-1813
Mailing Address - Country:US
Mailing Address - Phone:808-783-8322
Mailing Address - Fax:
Practice Address - Street 1:1925 KALAKAUA AVE APT 2701
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96815-1813
Practice Address - Country:US
Practice Address - Phone:808-783-8322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-06
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HILCSW-49321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical