Provider Demographics
NPI:1124857040
Name:KANAKAOLE, AIYANA L (LCSW)
Entity type:Individual
Prefix:
First Name:AIYANA
Middle Name:L
Last Name:KANAKAOLE
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 1:153 E KAMEHAMEHA AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:KAHULUI
Mailing Address - State:HI
Mailing Address - Zip Code:96732-3424
Mailing Address - Country:US
Mailing Address - Phone:808-825-4610
Mailing Address - Fax:808-825-4611
Practice Address - Street 1:153 E KAMEHAMEHA AVE STE 104
Practice Address - Street 2:
Practice Address - City:KAHULUI
Practice Address - State:HI
Practice Address - Zip Code:96732-3424
Practice Address - Country:US
Practice Address - Phone:808-825-4610
Practice Address - Fax:808-825-4611
Is Sole Proprietor?:No
Enumeration Date:2024-07-30
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI50241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical