Provider Demographics
NPI:1811734007
Name:MACRI, TANYA (MSW)
Entity type:Individual
Prefix:
First Name:TANYA
Middle Name:
Last Name:MACRI
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1034 QUEEN ST FL 2
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-4116
Mailing Address - Country:US
Mailing Address - Phone:808-228-0830
Mailing Address - Fax:
Practice Address - Street 1:1345 S BERETANIA ST STE 301
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-1802
Practice Address - Country:US
Practice Address - Phone:808-490-5723
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-13
Last Update Date:2024-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
HI171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No104100000XBehavioral Health & Social Service ProvidersSocial Worker