Provider Demographics
NPI:1780384057
Name:ALISON BROMLEY LCSW LLC
Entity type:Organization
Organization Name:ALISON BROMLEY LCSW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALISON
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:BROMLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:808-442-2439
Mailing Address - Street 1:131 HOOWAIWAI LOOP APT 2204
Mailing Address - Street 2:
Mailing Address - City:WAILUKU
Mailing Address - State:HI
Mailing Address - Zip Code:96793-4125
Mailing Address - Country:US
Mailing Address - Phone:808-442-2439
Mailing Address - Fax:
Practice Address - Street 1:131 HOOWAIWAI LOOP APT 2204
Practice Address - Street 2:
Practice Address - City:WAILUKU
Practice Address - State:HI
Practice Address - Zip Code:96793-4125
Practice Address - Country:US
Practice Address - Phone:808-442-2439
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-06
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)