Provider Demographics
NPI:1699989228
Name:RAGO, ELIZABETH JOANNE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:JOANNE
Last Name:RAGO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55-550 NANILOA LOOP
Mailing Address - Street 2:#6318
Mailing Address - City:LAIE
Mailing Address - State:HI
Mailing Address - Zip Code:96762-1267
Mailing Address - Country:US
Mailing Address - Phone:808-293-8100
Mailing Address - Fax:
Practice Address - Street 1:55-550 NANILOA LOOP
Practice Address - Street 2:#6318
Practice Address - City:LAIE
Practice Address - State:HI
Practice Address - Zip Code:96762-1267
Practice Address - Country:US
Practice Address - Phone:808-293-8100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2022-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI34181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical