Awaken Insight
Organization Active NPI Clinical Social Worker · Volcano, HI
NPI 1689216616 · NPPES record last updated Jul 6, 2023
Key facts
- NPI
- 1689216616
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinical Social Worker 1041C0700X
- Legal business name
- AWAKEN INSIGHT
- Practice address
- 11-3784 2ND St
Volcano, HI 96785 - Phone
- (210) 527-8755
- Fax
- (210) 714-9757
- NPI assigned
- Oct 10, 2019
- Organization subpart
- No
Authorized official
- Name
- Jesse Ryan Cardin, LCSW
- Title
- Founder/Owner/Manager/Provider
- Phone
- (210) 527-8755
Practitioners 1
-
Jesse Ryan Cardin, LCSW
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20191227001889 | TX | Part B Supplier - Clinic/Group Practice | 6800220880 |
Receives reassigned benefits from 1 practitioner Practice locations: Dallas, TX |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker |
1041C0700X | Yes |
Addresses
Primary practice location
11-3784 2ND St
Volcano, HI 96785
Mailing address
2186 Jackson Keller Rd
PMB 3081
San Antonio, TX 78213
Phone (210) 527-8755
Other providers in Volcano, HI
- Ahua Life Counseling, LLC
- Anne Marie Leilani Briggs
- Nicole Bulacan
- Jesse Ryan Cardin
- Compassion Focused Therapy LLC
- Christin Decoito
All providers in Volcano, HI · Clinical Social Worker in Hawaii
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 6, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.