Provider Demographics
NPI:1780979674
Name:LOFLAND, ANN RENEE (LCSW)
Entity type:Individual
Prefix:MS
First Name:ANN
Middle Name:RENEE
Last Name:LOFLAND
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:RENEE
Other - Last Name:LYON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:77-180 MAHIEHIE ST
Mailing Address - Street 2:
Mailing Address - City:KAILUA KONA
Mailing Address - State:HI
Mailing Address - Zip Code:96740-4431
Mailing Address - Country:US
Mailing Address - Phone:808-938-6644
Mailing Address - Fax:808-568-2599
Practice Address - Street 1:77-180 MAHIEHIE ST
Practice Address - Street 2:
Practice Address - City:KAILUA KONA
Practice Address - State:HI
Practice Address - Zip Code:96740-4431
Practice Address - Country:US
Practice Address - Phone:808-938-6644
Practice Address - Fax:808-568-2599
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-18
Last Update Date:2011-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI37101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical