Provider Demographics
NPI:1932335700
Name:YARBROUGH, TEPAIRU KEVP (MSW, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:TEPAIRU
Middle Name:KEVP
Last Name:YARBROUGH
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41-038 KAULU ST
Mailing Address - Street 2:
Mailing Address - City:WAIMANALO
Mailing Address - State:HI
Mailing Address - Zip Code:96795-1612
Mailing Address - Country:US
Mailing Address - Phone:808-358-2803
Mailing Address - Fax:
Practice Address - Street 1:6650 HAWAII KAI DR 202
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96825-1144
Practice Address - Country:US
Practice Address - Phone:808-464-7510
Practice Address - Fax:877-281-9428
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-05
Last Update Date:2015-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
HI40661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker