Individual provider Active NPI

Joan Ellevera Lanzaderas, MSW

  • Social Worker
  • Honolulu, HI
National Provider Identifier
1326523788
Registry record updated Jun 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
1330 Ala Moana Blvd Ste 1
Honolulu, HI 96814-4262
Phone
(808) 585-1424
NPI assigned
Oct 1, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 60896584 WA
Social Worker 104100000X HI Primary

Addresses

Primary practice location

1330 Ala Moana Blvd Ste 1
Honolulu, HI 96814-4262

Mailing address

1330 Ala Moana Blvd Ste 1
Honolulu, HI 96814-4262
Phone (808) 585-1424

Other practice location 1

999 164th Ave NE
Bellevue, WA 98008-3518
Phone (425) 747-4937

Other practice location 2

6400 Southcenter Blvd
Tukwila, WA 98188-2547
Phone (206) 444-3600

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

LicenseStateTypeSpecialty
60896584WAMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Hawaii Behavioral Health, LLC CurrentSince Dec 18, 2022 Accepting new patients
Hawaii Behavioral Health, LLC CurrentSince Nov 9, 2021 Accepting new patients
Youth Eastside Services Past Accepting new patients

Locations

1330 Ala Moana Blvd
Ste 1
Honolulu, HI 96814
Phone (800) 585-0379

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1538352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623196800000",
    "number": "1326523788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 ALA MOANA BLVD STE 1",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968144262",
            "telephone_number": "808-585-1424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 ALA MOANA BLVD STE 1",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968144262",
            "telephone_number": "808-585-1424"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "999 164th Ave NE",
            "address_purpose": "LOCATION",
            "city": "Bellevue",
            "state": "WA",
            "postal_code": "980083518",
            "country_code": "US",
            "telephone_number": "425-747-4937",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6400 Southcenter Blvd",
            "address_purpose": "LOCATION",
            "city": "Tukwila",
            "state": "WA",
            "postal_code": "981882547",
            "country_code": "US",
            "telephone_number": "206-444-3600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LANZADERAS",
        "first_name": "JOAN",
        "middle_name": "ELLEVERA",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-01",
        "last_updated": "2021-06-09",
        "certification_date": "2021-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WA",
            "license": "60896584",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "HI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.