Provider Demographics
NPI:1780296665
Name:AMERSON, YOLANDA R (LCSW)
Entity type:Individual
Prefix:MRS
First Name:YOLANDA
Middle Name:R
Last Name:AMERSON
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 1:1188 BISHOP ST STE 3206
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-3313
Mailing Address - Country:US
Mailing Address - Phone:808-255-2604
Mailing Address - Fax:
Practice Address - Street 1:1188 BISHOP ST STE 3206
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-3313
Practice Address - Country:US
Practice Address - Phone:808-255-2604
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-20
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HILCSW-47911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty