Henry A Granda, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW-3369 Issued in HI

Practice address

4643B Waimea Canyon Drive
Waimea, HI 96796

Phone

(808) 240-0154

Fax

(808) 338-1606

NPI assigned

Jul 31, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in HI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Hoola Lahui Hawaii

  • Federally Qualified Health Center (FQHC)
  • Waimea, HI
  • NPI 1245269976

  HI

  Medicare reassignment NPD
• Hoola Lahui Hawaii

  • Federally Qualified Health Center (FQHC)
  • Kapaa, HI
  • NPI 1891098513
  NPD

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1346256138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3990",
            "city": "LIHUE",
            "state": "HI",
            "postal_code": "967666990",
            "telephone_number": "808-240-0100",
            "fax_number": "808-245-8867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4643B WAIMEA CANYON DRIVE",
            "city": "WAIMEA",
            "state": "HI",
            "postal_code": "96796",
            "telephone_number": "808-240-0154",
            "fax_number": "808-338-1606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANDA",
        "first_name": "HENRY",
        "middle_name": "A",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "HI",
            "license": "LCSW-3369",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "523979-01",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kenneth Fasig, DDS
• Sara Fromboluti, PST.D.
• Stephanie Funtanilla, BA
• Garden Island Pharmacy Serv, Inc
• Adi Gjolla
• David Deland Gregorius, D.O.
• Guardian Flight LLC
• Amy Guyton, M.D.
• Kevin Guyton, MD
• Hawaii Institute of Innovation

• All providers in Waimea, HI
• Clinical Social Worker in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.