Provider Demographics
NPI:1104882398
Name:KANIAUPIO, TERRY ANN (LCSW)
Entity type:Individual
Prefix:MRS
First Name:TERRY
Middle Name:ANN
Last Name:KANIAUPIO
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 1:45-686 HALEMUKU WAY
Mailing Address - Street 2:
Mailing Address - City:KANEOHE
Mailing Address - State:HI
Mailing Address - Zip Code:96744-3163
Mailing Address - Country:US
Mailing Address - Phone:808-222-2729
Mailing Address - Fax:088-247-4891
Practice Address - Street 1:45-955 KAMEHAMEHA HWY STE 401
Practice Address - Street 2:
Practice Address - City:KANEOHE
Practice Address - State:HI
Practice Address - Zip Code:96744-3222
Practice Address - Country:US
Practice Address - Phone:808-222-2729
Practice Address - Fax:808-247-4891
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-25
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HILCSW-31931041C0700X
HILCSW#31931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI004781Medicaid
HI528242Medicaid
HILCSW-3193OtherBEHAVIORAL HEALTH OR MENTAL HEALTH