Provider Demographics
NPI:1558518043
Name:KAWANISHI, MIHO (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MIHO
Middle Name:
Last Name:KAWANISHI
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 1:500 LINDA AVE
Mailing Address - Street 2:PO BOX 297
Mailing Address - City:HAWTHORNE
Mailing Address - State:NY
Mailing Address - Zip Code:10532-1313
Mailing Address - Country:US
Mailing Address - Phone:914-773-7545
Mailing Address - Fax:
Practice Address - Street 1:500 LINDA AVE
Practice Address - Street 2:
Practice Address - City:HAWTHORNE
Practice Address - State:NY
Practice Address - Zip Code:10532-1313
Practice Address - Country:US
Practice Address - Phone:914-773-7545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-26
Last Update Date:2008-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR050673-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker