Provider Demographics
NPI:1952381337
Name:CHELMINIAK, STEVEN J (LCSW)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:J
Last Name:CHELMINIAK
Suffix:
Gender:M
Credentials:LCSW
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 2099
Mailing Address - Street 2:
Mailing Address - City:KAMUELA
Mailing Address - State:HI
Mailing Address - Zip Code:96743-2099
Mailing Address - Country:US
Mailing Address - Phone:808-885-5050
Mailing Address - Fax:808-885-5055
Practice Address - Street 1:65-1279 KAWAIHAE RD
Practice Address - Street 2:
Practice Address - City:KAMUELA
Practice Address - State:HI
Practice Address - Zip Code:96743-8444
Practice Address - Country:US
Practice Address - Phone:808-885-5050
Practice Address - Fax:808-885-5055
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-20
Last Update Date:2016-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HILCSW3213101YM0800X, 1041C0700X
HICSAC 692-7522-7517101YA0400X
103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI51864901Medicaid
Q06877Medicare UPIN