Provider Demographics
NPI:1760378210
Name:MAWUSI, KWANZAA (LCSW)
Entity type:Individual
Prefix:
First Name:KWANZAA
Middle Name:
Last Name:MAWUSI
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 1:117 POSEIDON DR
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23602-7359
Mailing Address - Country:US
Mailing Address - Phone:757-817-6305
Mailing Address - Fax:
Practice Address - Street 1:15 RESEARCH DR STE A
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-1324
Practice Address - Country:US
Practice Address - Phone:757-315-8039
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-12
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040184531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical