Provider Demographics
NPI:1013298132
Name:SCHWEITZER, SHELLEY K (LCSW, BCBA)
Entity Type:Individual
Prefix:
First Name:SHELLEY
Middle Name:K
Last Name:SCHWEITZER
Suffix:
Gender:F
Credentials:LCSW, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2337 AUHUHU ST
Mailing Address - Street 2:
Mailing Address - City:PEARL CITY
Mailing Address - State:HI
Mailing Address - Zip Code:96782-1143
Mailing Address - Country:US
Mailing Address - Phone:808-277-2850
Mailing Address - Fax:
Practice Address - Street 1:2337 AUHUHU ST
Practice Address - Street 2:
Practice Address - City:PEARL CITY
Practice Address - State:HI
Practice Address - Zip Code:96782-1143
Practice Address - Country:US
Practice Address - Phone:808-277-2850
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-01
Last Update Date:2013-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HILCSW-35411041C0700X
103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst