Basic Information
Provider Information | |||||||||
NPI: | 1548636442 | ||||||||
EntityType: | 2 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: | KARIN STOLL, MSW, DCSW | ||||||||
LastName: |   | ||||||||
FirstName: |   | ||||||||
MiddleName: |   | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: |   | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 3412 HINAHINA ST | ||||||||
Address2: |   | ||||||||
City: | LIHUE | ||||||||
State: | HI | ||||||||
PostalCode: | 967661030 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 8086322010 | ||||||||
FaxNumber: |   | ||||||||
Practice Location | |||||||||
Address1: | 3146 AKAHI ST | ||||||||
Address2: |   | ||||||||
City: | LIHUE | ||||||||
State: | HI | ||||||||
PostalCode: | 967661105 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 8086322010 | ||||||||
FaxNumber: | 8086322101 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 08/13/2015 | ||||||||
LastUpdateDate: | 08/13/2015 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: |   | ||||||||
AuthorizedOfficialLastName: | STOLL | ||||||||
AuthorizedOfficialFirstName: | KARIN | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
AuthorizedOfficialTelephone: | 8086322010 | ||||||||
IsSoleProprietor: |   | ||||||||
IsOrganizationSubpart: | N | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: | MSW | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 3007 | HI | Y | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.