Provider Demographics
NPI:1780440552
Name:ANDREA KUMURA LCSW ACSW LLC
Entity type:Organization
Organization Name:ANDREA KUMURA LCSW ACSW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:AKEMI
Authorized Official - Last Name:KUMURA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:808-203-4250
Mailing Address - Street 1:4348 WAIALAE AVE # 526
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-5767
Mailing Address - Country:US
Mailing Address - Phone:808-203-4250
Mailing Address - Fax:808-201-5267
Practice Address - Street 1:3828A CLAUDINE ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-4378
Practice Address - Country:US
Practice Address - Phone:808-203-4250
Practice Address - Fax:808-201-5267
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-27
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health