Provider Demographics
NPI:1124561774
Name:STETTLER, ALICIA LOUISE (LCSW)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:LOUISE
Last Name:STETTLER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ALICIA
Other - Middle Name:LOUISE
Other - Last Name:HULL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CSW/LSW
Mailing Address - Street 1:1300 N HOLOPONO ST STE 108&213
Mailing Address - Street 2:
Mailing Address - City:KIHEI
Mailing Address - State:HI
Mailing Address - Zip Code:96753-6945
Mailing Address - Country:US
Mailing Address - Phone:808-206-9371
Mailing Address - Fax:855-270-7441
Practice Address - Street 1:1300 N HOLOPONO ST STE 108&213
Practice Address - Street 2:
Practice Address - City:KIHEI
Practice Address - State:HI
Practice Address - Zip Code:96753-6945
Practice Address - Country:US
Practice Address - Phone:808-206-9371
Practice Address - Fax:855-270-7441
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-30
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10167184-3502101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor