Provider Demographics
NPI:1215036009
Name:ORTIZ, CECILIA F (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:CECILIA
Middle Name:F
Last Name:ORTIZ
Suffix:
Gender:F
Credentials:MSW, LCSW
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 550
Mailing Address - Street 2:
Mailing Address - City:HAIKU
Mailing Address - State:HI
Mailing Address - Zip Code:96708-0550
Mailing Address - Country:US
Mailing Address - Phone:808-280-8288
Mailing Address - Fax:
Practice Address - Street 1:400 MAHALANI ST
Practice Address - Street 2:
Practice Address - City:WAILUKU
Practice Address - State:HI
Practice Address - Zip Code:96793-2547
Practice Address - Country:US
Practice Address - Phone:808-244-5555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HILCSW-44811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8902715OtherL&I CRIME VICTIMS