Provider Demographics
NPI:1285963835
Name:SU'ESU'E, LYNDA M (LCSW, ACSW)
Entity type:Individual
Prefix:
First Name:LYNDA
Middle Name:M
Last Name:SU'ESU'E
Suffix:
Gender:F
Credentials:LCSW, ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 492553
Mailing Address - Street 2:
Mailing Address - City:KEAAU
Mailing Address - State:HI
Mailing Address - Zip Code:96749-2553
Mailing Address - Country:US
Mailing Address - Phone:808-345-6711
Mailing Address - Fax:
Practice Address - Street 1:11 FURNEAUX LN
Practice Address - Street 2:# 213
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-2868
Practice Address - Country:US
Practice Address - Phone:808-345-6711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-10
Last Update Date:2010-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker