Provider Demographics
NPI:1043420854
Name:LUKE, STANLEY CM (PHD)
Entity Type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:CM
Last Name:LUKE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:218 ILIHAU ST
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-1654
Mailing Address - Country:US
Mailing Address - Phone:808-927-4928
Mailing Address - Fax:
Practice Address - Street 1:218 ILIHAU ST
Practice Address - Street 2:
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-1654
Practice Address - Country:US
Practice Address - Phone:808-927-4928
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPSY504103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist