Provider Demographics
NPI:1376320705
Name:STACY DALY LLC
Entity Type:Organization
Organization Name:STACY DALY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:STACY
Authorized Official - Middle Name:
Authorized Official - Last Name:DALY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:808-737-1007
Mailing Address - Street 1:1531 BERTRAM ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-1926
Mailing Address - Country:US
Mailing Address - Phone:808-772-1191
Mailing Address - Fax:
Practice Address - Street 1:1531 BERTRAM ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-1926
Practice Address - Country:US
Practice Address - Phone:808-772-1191
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-11
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health