Individual
TERI-ANN KINIMAKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, CSAC,CCJP, SAP
Contact information
Practice address
750 ALEWA DR, HONOLULU, HI 96817-1533
(808) 392-4813
(808) 590-2328
Mailing address
750 ALEWA DR, HONOLULU, HI 96817-1533
(808) 392-4813
(808) 590-2328
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CCDP-D 110-11
HI
101YA0400X
Addiction (Substance Use Disorder) Counselor
CCJP 330-11
HI
101YA0400X
Addiction (Substance Use Disorder) Counselor
CSAC 1687-12
HI
101YA0400X
Addiction (Substance Use Disorder) Counselor
SAP - 20478
HI
1041C0700X
Clinical Social Worker
Primary
LCSW-3383
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
627119
—
HI
Enumeration date
12/11/2006
Last updated
10/25/2022
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