Provider Demographics
NPI:1215260278
Name:DENNISON, HAYLIN ADRI YAEKO (LCSW)
Entity type:Individual
Prefix:
First Name:HAYLIN
Middle Name:ADRI YAEKO
Last Name:DENNISON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:HAYLIN
Other - Middle Name:
Other - Last Name:STROMBACH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:401 KAMAKEE ST STE 305
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-4243
Mailing Address - Country:US
Mailing Address - Phone:808-500-7134
Mailing Address - Fax:
Practice Address - Street 1:401 KAMAKEE ST STE 305
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-4243
Practice Address - Country:US
Practice Address - Phone:808-500-7134
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-09
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI39141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI778483Medicaid