Provider Demographics
NPI:1497724090
Name:GELLER, STEVEN EDWARD (PHD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:EDWARD
Last Name:GELLER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:181 LAHAINALUNA RD
Mailing Address - Street 2:SUITE K
Mailing Address - City:LAHAINA
Mailing Address - State:HI
Mailing Address - Zip Code:96761-1585
Mailing Address - Country:US
Mailing Address - Phone:808-661-8141
Mailing Address - Fax:808-568-2598
Practice Address - Street 1:181 LAHAINALUNA RD
Practice Address - Street 2:SUITE K
Practice Address - City:LAHAINA
Practice Address - State:HI
Practice Address - Zip Code:96761-1585
Practice Address - Country:US
Practice Address - Phone:808-661-8141
Practice Address - Fax:808-568-2598
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-16
Last Update Date:2013-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1954103TC0700X
HI1395103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical