Provider Demographics
NPI:1700653219
Name:BRIAN KANNO LCSW LLC
Entity Type:Organization
Organization Name:BRIAN KANNO LCSW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:MASATO
Authorized Official - Last Name:KANNO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:808-782-8900
Mailing Address - Street 1:95-1011 PUUKOA ST
Mailing Address - Street 2:
Mailing Address - City:MILILANI
Mailing Address - State:HI
Mailing Address - Zip Code:96789-6505
Mailing Address - Country:US
Mailing Address - Phone:808-782-8900
Mailing Address - Fax:808-748-0433
Practice Address - Street 1:95-1011 PUUKOA ST
Practice Address - Street 2:
Practice Address - City:MILILANI
Practice Address - State:HI
Practice Address - Zip Code:96789-6505
Practice Address - Country:US
Practice Address - Phone:808-782-8900
Practice Address - Fax:808-748-0433
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-05
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty