Provider Demographics
NPI:1245488063
Name:REPLOGLE, GARY STEVEN (MED, CSAC, LMHC)
Entity type:Individual
Prefix:
First Name:GARY
Middle Name:STEVEN
Last Name:REPLOGLE
Suffix:
Gender:M
Credentials:MED, CSAC, LMHC
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 55
Mailing Address - Street 2:
Mailing Address - City:HONOMU
Mailing Address - State:HI
Mailing Address - Zip Code:96728-0055
Mailing Address - Country:US
Mailing Address - Phone:808-963-6106
Mailing Address - Fax:
Practice Address - Street 1:234 WAIANUENUE AVE
Practice Address - Street 2:SUITE 107
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-2418
Practice Address - Country:US
Practice Address - Phone:808-217-7979
Practice Address - Fax:808-217-7979
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-04
Last Update Date:2012-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)