Provider Demographics
NPI:1083697387
Name:BALDWIN, HOWARD TIMOTHY (LCSW, DCSW)
Entity Type:Individual
Prefix:
First Name:HOWARD
Middle Name:TIMOTHY
Last Name:BALDWIN
Suffix:
Gender:M
Credentials:LCSW, DCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 11121
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96721-6121
Mailing Address - Country:US
Mailing Address - Phone:808-961-2811
Mailing Address - Fax:
Practice Address - Street 1:213 ULULANI ST
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-2628
Practice Address - Country:US
Practice Address - Phone:808-961-2811
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI31461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
0000230557OtherHMSA-QUEST PLAN
023055-7OtherHMSA
HI497942-01Medicaid
HILSW783OtherQUEEN'S HEALTH PLANS
P33588Medicare UPIN
0000230557OtherHMSA-QUEST PLAN