Healthcare Provider Details

I. General information

NPI: 1730712795
Provider Name (Legal Business Name): AKUA CAMPANELLA LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/18/2020
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

46-001 KAMEHAMEHA HWY
KANEOHE HI
96744-3711
US

IV. Provider business mailing address

1170 NUUANU AVE UNIT 37514
HONOLULU HI
96837-5622
US

V. Phone/Fax

Practice location:
  • Phone: 808-343-7484
  • Fax:
Mailing address:
  • Phone: 808-343-7484
  • Fax: 808-748-0989

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSWI.LW.70016361
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number122912
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number4506
License Number StateHI
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number4909C
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: