Provider Demographics
NPI:1407280035
Name:SCHANKER, JOEL ROBERT
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:ROBERT
Last Name:SCHANKER
Suffix:
Gender:M
Credentials:
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 880156
Mailing Address - Street 2:
Mailing Address - City:PUKALANI
Mailing Address - State:HI
Mailing Address - Zip Code:96788-0156
Mailing Address - Country:US
Mailing Address - Phone:808-573-8373
Mailing Address - Fax:
Practice Address - Street 1:145 MOKUPAPA RD
Practice Address - Street 2:
Practice Address - City:HAIKU
Practice Address - State:HI
Practice Address - Zip Code:96708
Practice Address - Country:US
Practice Address - Phone:808-573-8373
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-30
Last Update Date:2013-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor