Glenn A Kondo, DCSW LCSW CSAC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW3070 Issued in HI

Practice address

688 Kinoole St
Ste 119B
Hilo, HI 96720

Phone

(808) 935-5687

Fax

(808) 935-8873

NPI assigned

Oct 4, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

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

Specialty

Clinical Social Worker

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273017600000",
    "number": "1417042227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10621",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967211062",
            "telephone_number": "808-935-5687",
            "fax_number": "808-935-8873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "688 KINOOLE ST",
            "address_2": "STE 119B",
            "city": "HILO",
            "state": "HI",
            "postal_code": "96720",
            "telephone_number": "808-935-5687",
            "fax_number": "808-935-8873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONDO",
        "first_name": "GLENN",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "DCSW LCSW CSAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2010-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "HI",
            "license": "90193",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "HI",
            "license": "LCSW3070",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "A02141262",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kokua Counseling Services, Inc.
• Kokua Orthotic Solutions
• Antonio Komotar, LMHC
• Jaimelynn Kuualohalani Kon, PHARMD
• Kona Therapy Associates Inc.
• Helene Kong, LMT, CMT
• Kelly N Korn, MSN, FNP-C
• Joan Krakowiak, MSW, LICSW
• Ashleigh Kramer-Walthall
• Dean Kroh

• Clinical Social Worker in Hilo, HI
• Providers in Hilo, HI by specialty
• Clinical Social Worker in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2010; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.