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General NPI Number Information
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NPI Number | 1679142699
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Entity Type | Individual
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Provider Name | JOY NY TANIMURA WINQUIST LCSW
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Gender | Female
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Dates
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Enumeration Date | 06/23/2021
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Last Update Date | 08/31/2021
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Provider Practice Location Address
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Address Line | 1127 11TH AVE STE 301
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City | HONOLULU
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State | HI
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Zip | 96816-2443
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Country | US
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Telephone | 808-773-4560
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Fax |
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Provider Business Mailing Address
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Address Line | 3495 E MANOA RD
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City | HONOLULU
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State | HI
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Zip | 96822-1332
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Country | US
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Telephone | 808-392-3340
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 149.017759
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 4180
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License Number State | HI
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