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General NPI Number Information
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NPI Number | 1710084223
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Entity Type | Organization
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Legal Business Name | TED KAWA CHILD & FAMILY COUNSELING PC
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Dates
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Enumeration Date | 09/19/2006
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Last Update Date | 07/08/2009
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Provider Practice Location Address
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Address Line | 1811 W 2ND STREET SUITE 435
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City | GRAND ISLAND
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State | NE
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Zip | 68803-5413
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Country | US
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Telephone | 308-389-6160
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Fax | 308-381-0658
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Provider Business Mailing Address
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Address Line | 1811 W 2ND STREET SUITE 435
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City | GRAND ISLAND
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State | NE
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Zip | 68803-5413
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Country | US
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Telephone | 308-389-6160
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Fax | 308-381-0658
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. TED KAWA
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Credential | LCSW
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Telephone | 308-389-6160
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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 |
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License Number State |
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