Provider Demographics
NPI:1730712795
Name:CAMPANELLA, AKUA (LCSW)
Entity type:Individual
Prefix:
First Name:AKUA
Middle Name:
Last Name:CAMPANELLA
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 1:1170 NUUANU AVE STE 105
Mailing Address - Street 2:BOX 37514
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817
Mailing Address - Country:US
Mailing Address - Phone:808-343-7484
Mailing Address - Fax:
Practice Address - Street 1:46-001 KAMEHAMEHA HWY
Practice Address - Street 2:
Practice Address - City:KANEOHE
Practice Address - State:HI
Practice Address - Zip Code:96744-3711
Practice Address - Country:US
Practice Address - Phone:808-343-7484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-18
Last Update Date:2020-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID45061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical