Provider Demographics
NPI:1497926190
Name:KAWASAKI, AYA BRANCH (LCSW)
Entity Type:Individual
Prefix:
First Name:AYA
Middle Name:BRANCH
Last Name:KAWASAKI
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 1:3460 HAMPTON AVE STE 106
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63139-1938
Mailing Address - Country:US
Mailing Address - Phone:314-479-1670
Mailing Address - Fax:314-261-5029
Practice Address - Street 1:3460 HAMPTON AVE STE 106
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63139-1938
Practice Address - Country:US
Practice Address - Phone:314-479-1670
Practice Address - Fax:314-261-5029
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-20
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20030262521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical