Individual provider Active NPI

Larisa Hisako Nebre, MSW, LCSW

  • Clinical Social Worker
  • Kilauea, HI
National Provider Identifier
1407623143
Registry record updated Dec 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW-5108 Issued in HI
Practice address
4343 Aalona St
Kilauea, HI 96754-5344
Phone
(808) 635-2114
NPI assigned
Dec 4, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW-5108 HI Primary

Addresses

Primary practice location

4343 Aalona St
Kilauea, HI 96754-5344

Mailing address

4343 Aalona St
Kilauea, HI 96754-5344
Phone (808) 635-2114

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW-5108HIMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1701648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701648000000",
    "number": "1407623143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4343 AALONA ST",
            "city": "KILAUEA",
            "state": "HI",
            "postal_code": "967545344",
            "telephone_number": "808-635-2114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4343 AALONA ST",
            "city": "KILAUEA",
            "state": "HI",
            "postal_code": "967545344",
            "telephone_number": "808-635-2114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEBRE",
        "first_name": "LARISA",
        "middle_name": "HISAKO",
        "name_prefix": "Ms.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-04",
        "last_updated": "2023-12-04",
        "certification_date": "2023-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "HI",
            "license": "LCSW-5108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kilauea, HI

Sources for this page

Verify at the official NPI Registry.