Provider Demographics
NPI:1861795726
Name:LLOYD, MARISA K (LCSW, CSAC)
Entity type:Individual
Prefix:MS
First Name:MARISA
Middle Name:K
Last Name:LLOYD
Suffix:
Gender:F
Credentials:LCSW, CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:460 ENA RD STE 505
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96815-1774
Mailing Address - Country:US
Mailing Address - Phone:415-320-6697
Mailing Address - Fax:
Practice Address - Street 1:460 ENA RD STE 505
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96815-1774
Practice Address - Country:US
Practice Address - Phone:415-320-6697
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-15
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW-614291041C0700X
WALCSW-LW615090721041C0700X
HILCSW-41311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical