Healthcare Provider Details

I. General information

NPI: 1023163680
Provider Name (Legal Business Name): CHEYENNE T AKANA LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 05/18/2020
Certification Date: 05/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 S KUKUI ST APT D715
HONOLULU HI
96813-2345
US

IV. Provider business mailing address

PO BOX 240502
HONOLULU HI
96824-0502
US

V. Phone/Fax

Practice location:
  • Phone: 808-429-8226
  • Fax: 888-871-1150
Mailing address:
  • Phone: 808-429-8226
  • Fax: 888-871-1150

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW-3307
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: