Provider Demographics
NPI:1437428356
Name:KANIUKA, WILLIAM PIERS (MA, MTS)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:PIERS
Last Name:KANIUKA
Suffix:
Gender:M
Credentials:MA, MTS
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 983
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:ME
Mailing Address - Zip Code:04011-0983
Mailing Address - Country:US
Mailing Address - Phone:207-208-0995
Mailing Address - Fax:
Practice Address - Street 1:244 HIGH WATCH RD
Practice Address - Street 2:
Practice Address - City:EFFINGHAM
Practice Address - State:NH
Practice Address - Zip Code:03882
Practice Address - Country:US
Practice Address - Phone:603-539-8808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-21
Last Update Date:2019-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECAC5116101YA0400X
MEXL3899101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)