Provider Demographics
NPI:1306288550
Name:DIVINSKI, PAUL R (LCSW)
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:R
Last Name:DIVINSKI
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 1:16-179 MELEKAHIWA STREET
Mailing Address - Street 2:
Mailing Address - City:KEA'AU
Mailing Address - State:HI
Mailing Address - Zip Code:96749
Mailing Address - Country:US
Mailing Address - Phone:808-969-9994
Mailing Address - Fax:808-961-5011
Practice Address - Street 1:295 WAIANUEUE AVE
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720
Practice Address - Country:US
Practice Address - Phone:808-959-9994
Practice Address - Fax:808-969-3716
Is Sole Proprietor?:No
Enumeration Date:2013-07-29
Last Update Date:2013-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HILCSW-3863104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker