Provider Demographics
NPI:1720244718
Name:THOMAS, JAN KANANI (MSCP,NCC,LMHC,CSAC)
Entity Type:Individual
Prefix:MRS
First Name:JAN
Middle Name:KANANI
Last Name:THOMAS
Suffix:
Gender:F
Credentials:MSCP,NCC,LMHC,CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1751
Mailing Address - Street 2:
Mailing Address - City:KAUNAKAKAI
Mailing Address - State:HI
Mailing Address - Zip Code:96748-1751
Mailing Address - Country:US
Mailing Address - Phone:808-553-5556
Mailing Address - Fax:
Practice Address - Street 1:357 ULUA ROAD
Practice Address - Street 2:
Practice Address - City:KAUNAKAKAI
Practice Address - State:HI
Practice Address - Zip Code:96748-1751
Practice Address - Country:US
Practice Address - Phone:808-741-3223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-30
Last Update Date:2011-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1117-02101YA0400X
HI22453101YA0400X
HI24101YM0800X
HI60478101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)