Healthcare Provider Details

I. General information

NPI: 1265254536
Provider Name (Legal Business Name): EMILY PYE LOMAX ALECKSON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/29/2024
Last Update Date: 10/29/2024
Certification Date: 10/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 POWERS ST
SANTA RITA GU
96915-1133
US

IV. Provider business mailing address

3 POWERS ST
SANTA RITA GU
96915-1133
US

V. Phone/Fax

Practice location:
  • Phone: 671-864-2694
  • Fax:
Mailing address:
  • Phone: 671-864-2694
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW-5103
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: