Provider Demographics
NPI:1285269563
Name:CANO-YOUNG, CHRISTINA M (LCSW)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:M
Last Name:CANO-YOUNG
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:PO BOX 1034
Mailing Address - Street 2:
Mailing Address - City:KOLOA
Mailing Address - State:HI
Mailing Address - Zip Code:96756-1034
Mailing Address - Country:US
Mailing Address - Phone:808-353-1886
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 1034
Practice Address - Street 2:
Practice Address - City:KOLOA
Practice Address - State:HI
Practice Address - Zip Code:96756-1034
Practice Address - Country:US
Practice Address - Phone:808-353-1886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-07
Last Update Date:2024-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HILCSW-50181041C0700X, 101Y00000X, 101YA0400X, 101YM0800X
ORL11218101YA0400X, 101YM0800X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health