Provider Demographics
NPI:1427878784
Name:QUERUBIN, ALIKA B (MSW, LCSW)
Entity type:Individual
Prefix:MR
First Name:ALIKA
Middle Name:B
Last Name:QUERUBIN
Suffix:
Gender:M
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 1:917 KUKUAU ST
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-6001
Mailing Address - Country:US
Mailing Address - Phone:808-364-6817
Mailing Address - Fax:
Practice Address - Street 1:917 KUKUAU ST
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-6001
Practice Address - Country:US
Practice Address - Phone:808-364-6817
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-11
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HILCSW-52231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical