Active NPI
Daniel Edwards, LCSW, MPA
- Clinical Social Worker
- Kailua Kona, HI
National Provider Identifier
1033539267
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 149.016604
- Practice address
- 75-374 Nani Kailua Dr
Kailua Kona, HI 96740-1936 - Phone
- (808) 557-1962
- Fax
- (808) 443-0026
- NPI assigned
- Apr 28, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 149.016604 | IL | Primary |
Addresses
Primary practice location
75-374 Nani Kailua Dr
Kailua Kona, HI 96740-1936
Mailing address
75-374 Nani Kailua Dr
Kailua Kona, HI 96740-1936
Phone (808) 557-1962
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 149.016604 | Medicaid | IL | |
| HI-4292 | Other | HI | LCSW |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 149.016604 | IL | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1398643200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1652486400000",
"number": "1033539267",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "75-374 NANI KAILUA DR",
"city": "KAILUA KONA",
"state": "HI",
"postal_code": "967401936",
"telephone_number": "808-557-1962",
"fax_number": "808-443-0026"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "75-374 NANI KAILUA DR",
"city": "KAILUA KONA",
"state": "HI",
"postal_code": "967401936",
"telephone_number": "808-557-1962",
"fax_number": "808-443-0026"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDWARDS",
"first_name": "DANIEL",
"name_prefix": "Mr.",
"credential": "LCSW, MPA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-04-28",
"last_updated": "2022-05-14",
"certification_date": "2022-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149.016604",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "149.016604",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LCSW",
"identifier": "HI-4292",
"state": "HI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kailua Kona, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.