Individual provider Active NPI

Anita Louise Laviola, LCSW

  • Clinical Social Worker
  • Wailuku, HI
National Provider Identifier
1477728665
Registry record updated Jun 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW 3041 Issued in HI
Practice address
2200 Main St Ste 528
Wailuku, HI 96793-1640
Phone
(808) 281-2340
NPI assigned
Apr 28, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW 3041 HI Primary

Addresses

Primary practice location

2200 Main St Ste 528
Wailuku, HI 96793-1640

Mailing address

2200 Main St Ste 528
Wailuku, HI 96793-1640
Phone (808) 281-2340

Other practice location 1

2200 Main St Ste 510
Wailuku, HI 96793-1624
Phone (808) 281-2340

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20180814004336 HI Practitioner - Clinical Social Worker 3971804535

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW 3041HIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1209340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624492800000",
    "number": "1477728665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 MAIN ST STE 528",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "967931640",
            "telephone_number": "808-281-2340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 MAIN ST STE 528",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "967931640",
            "telephone_number": "808-281-2340"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2200 Main St Ste 510",
            "address_purpose": "LOCATION",
            "city": "Wailuku",
            "state": "HI",
            "postal_code": "967931624",
            "country_code": "US",
            "telephone_number": "808-281-2340",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAVIOLA",
        "first_name": "ANITA",
        "middle_name": "LOUISE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-28",
        "last_updated": "2021-06-24",
        "certification_date": "2021-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "HI",
            "license": "LCSW 3041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wailuku, HI

Sources for this page

Verify at the official NPI Registry.