Provider Demographics
NPI:1407843147
Name:STOLL, KARIN AVIS (LCSW, DCSW)
Entity Type:Individual
Prefix:MS
First Name:KARIN
Middle Name:AVIS
Last Name:STOLL
Suffix:
Gender:F
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 1:3412 HINAHINA ST
Mailing Address - Street 2:
Mailing Address - City:LIHUE
Mailing Address - State:HI
Mailing Address - Zip Code:96766-1030
Mailing Address - Country:US
Mailing Address - Phone:808-632-2010
Mailing Address - Fax:808-632-2101
Practice Address - Street 1:3146 AKAHI ST
Practice Address - Street 2:
Practice Address - City:LIHUE
Practice Address - State:HI
Practice Address - Zip Code:96766-1105
Practice Address - Country:US
Practice Address - Phone:808-632-2010
Practice Address - Fax:808-632-2101
Is Sole Proprietor?:No
Enumeration Date:2005-09-27
Last Update Date:2007-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HILCSW-3007101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI24648701Medicaid
HI24648701Medicaid
HIS41504Medicare UPIN