Provider Demographics
NPI:1467121566
Name:CHIKAZAWA, KYLE (LCSW)
Entity Type:Individual
Prefix:
First Name:KYLE
Middle Name:
Last Name:CHIKAZAWA
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99-080 KAUHALE ST STE C20
Mailing Address - Street 2:
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-4114
Mailing Address - Country:US
Mailing Address - Phone:808-284-3903
Mailing Address - Fax:
Practice Address - Street 1:99-080 KAUHALE ST STE C20
Practice Address - Street 2:
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-4114
Practice Address - Country:US
Practice Address - Phone:808-284-3903
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-10
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI45151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical