Provider Demographics
NPI:1033357058
Name:GOODIER, CAILIN
Entity Type:Individual
Prefix:
First Name:CAILIN
Middle Name:
Last Name:GOODIER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3339 IOLANI ST
Mailing Address - Street 2:
Mailing Address - City:MAKAWAO
Mailing Address - State:HI
Mailing Address - Zip Code:96768-8538
Mailing Address - Country:US
Mailing Address - Phone:808-633-3418
Mailing Address - Fax:
Practice Address - Street 1:451 KAIOLOHIA ST
Practice Address - Street 2:
Practice Address - City:KIHEI
Practice Address - State:HI
Practice Address - Zip Code:96753-7634
Practice Address - Country:US
Practice Address - Phone:808-633-3418
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-29
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RICSW011671041C0700X
HILCSW-37061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical