Healthcare Provider Details

I. General information

NPI: 1053523977
Provider Name (Legal Business Name): LAVERNE LANIUMA RIVAS LCSW BCD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAVERNE LANIUMA TONG LCSW BCD

II. Dates (important events)

Enumeration Date: 05/04/2007
Last Update Date: 12/28/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1485 LINAPUNI ST. STE 105
HONOLULU HI
96819
US

IV. Provider business mailing address

PO BOX 968
HALEIWA HI
96712
US

V. Phone/Fax

Practice location:
  • Phone: 808-722-0892
  • Fax: 808-848-2069
Mailing address:
  • Phone: 808-722-0892
  • Fax: 808-848-2069

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number3336
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: