Provider Demographics
NPI:1457764722
Name:GOVE, ERIN YAMAMOTO (LCSW)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:YAMAMOTO
Last Name:GOVE
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 1:59-012 HUELO ST
Mailing Address - Street 2:
Mailing Address - City:HALEIWA
Mailing Address - State:HI
Mailing Address - Zip Code:96712-9710
Mailing Address - Country:US
Mailing Address - Phone:808-628-0152
Mailing Address - Fax:
Practice Address - Street 1:59-012 HUELO ST
Practice Address - Street 2:
Practice Address - City:HALEIWA
Practice Address - State:HI
Practice Address - Zip Code:96712-9710
Practice Address - Country:US
Practice Address - Phone:808-628-0152
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-04
Last Update Date:2021-08-18
Deactivation Date:2020-12-29
Deactivation Code:
Reactivation Date:2021-04-28
Provider Licenses
StateLicense IDTaxonomies
HI2086104100000X
HI43201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker