Provider Demographics
NPI:1871299750
Name:LOURO, ELISE MARIE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:ELISE
Middle Name:MARIE
Last Name:LOURO
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68-055 AKULE ST APT 110
Mailing Address - Street 2:
Mailing Address - City:WAIALUA
Mailing Address - State:HI
Mailing Address - Zip Code:96791-9412
Mailing Address - Country:US
Mailing Address - Phone:631-974-4395
Mailing Address - Fax:
Practice Address - Street 1:68-024 APUHIHI ST APT W105
Practice Address - Street 2:
Practice Address - City:WAIALUA
Practice Address - State:HI
Practice Address - Zip Code:96791-9449
Practice Address - Country:US
Practice Address - Phone:631-974-4395
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-02
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI49081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical