Provider Demographics
NPI:1174796916
Name:SHAMAL, NAZO (PSYD, LCSW)
Entity type:Individual
Prefix:
First Name:NAZO
Middle Name:
Last Name:SHAMAL
Suffix:
Gender:F
Credentials:PSYD, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2146 DAMON ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96822-2139
Mailing Address - Country:US
Mailing Address - Phone:808-754-9181
Mailing Address - Fax:
Practice Address - Street 1:2146 DAMON ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96822-2139
Practice Address - Country:US
Practice Address - Phone:808-754-9181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-11
Last Update Date:2016-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HILCSW-33861041C0700X
VA09040086521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical