Provider Demographics
NPI:1073372710
Name:STAGNER, CARMAEL (CSAC, CCS, CCJP)
Entity Type:Individual
Prefix:
First Name:CARMAEL
Middle Name:
Last Name:STAGNER
Suffix:
Gender:F
Credentials:CSAC, CCS, CCJP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 691 KEAAHALA ROAD
Mailing Address - Street 2:F
Mailing Address - City:KANEOHE
Mailing Address - State:HI
Mailing Address - Zip Code:96744-0600
Mailing Address - Country:US
Mailing Address - Phone:808-233-3775
Mailing Address - Fax:808-233-3779
Practice Address - Street 1:45 691 KEAAHALA ROAD
Practice Address - Street 2:F
Practice Address - City:KANEOHE
Practice Address - State:HI
Practice Address - Zip Code:96744-0600
Practice Address - Country:US
Practice Address - Phone:808-233-3775
Practice Address - Fax:808-233-3779
Is Sole Proprietor?:No
Enumeration Date:2024-03-15
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1182-03101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)